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Alterations in c‐MET, a tyrosine kinase receptor encoded by the MET gene, have been reported in approximately 3% of non‐small cell lung cancer (NSCLC) cases and carry important treatment implications. The best studied genetic alterations are exon 14 skipping and gene amplification; however, gene rearrangement has also been described, and multiple fusion partners have been reported. Recently, in METex14‐mutated NSCLC, multitarget tyrosine kinase inhibitors (TKIs), such as crizotinib and cabozantinib, as well as MET‐selective TKIs, such as tepotinib and capmatinib, have demonstrated durable responses. In this study, we present the case of a 41‐year‐old woman with advanced NSCLC harboring an HLA‐DRB1‐MET gene fusion. The patient was offered successively two different MET multikinase inhibitors, crizotinib and cabozantinib, and the selective inhibitor tepotinib. Each time, including under tepotinib, the patient experienced rapid and complete responses associated with a tremendous improvement in her physical function. Key Points: To our knowledge, this is the first report of a patient with non‐small cell lung cancer harboring an HLA‐DRB1‐MET gene fusion demonstrating a clinical response to multiple MET inhibitors, including tepotinib.This finding illustrates the efficacy and rationale to targeting MET regardless of fusion partner and gives insight to pooling of patients with different MET fusion products in trials assessing safety and efficacy of novel molecules. This article provides a promising report of tepotinib efficacy in a patient with non‐small cell lung cancer harboring an HLA‐DRB1‐MET gene fusion. [ABSTRACT FROM AUTHOR]

Background. Uncertainty persists about the survival advantage of concomitant and adjuvant temozolomide (TMZ) plus radiotherapy (RT) in elderly patients with newly diagnosed glioblastoma (GBM). We compared the clinical outcome of unselected elderly GBM patients treated with 4 adjuvant treatment modalities, including the Stupp protocol. Methods. From 2010 to 2014, retrospective chart review was performed on 171 GBM patients aged =55 who received either concurrent chemoradiation therapy (CCRT) with standard 60 Gy/30 (SRT); CCRT with hypofractionated 40 Gy/15 (HRT); HRT alone; or TMZ alone. Stratification is by age (55-69, =70), KPS (<70, =70), and resection status (biopsy, resection). Results. Out of 171 patients identified, 128(75%) had surgical resection, median age was 66(55-83), and median overall survival (mOS) 11.4mo. Majority (109/171) were treated according to the Stupp protocol (CCRT-SRT), and 106/171 received post-CCRT adjuvant TMZ (median of 3 cycles). In our population, age <70yo was a significant prognostic factor (mOS of patients aged 55-69 vs =70 yo = 13.3 vs 6.6 mo; P = .001). However, among the population receiving the Stupp regimen, there was no difference in survival between patients aged 55-69 and those =70 (respectively, 14.4 vs 13.2 mo; P = .798). Patients =70 yo had similar survival when treated with CCRT-HRT and CCRTSRT (P = .248), although numbers were small. Conclusions. Our data suggests that, despite having a worse global prognostic than their younger counterparts, GBM patients =70yo with a good performance status could be treated according to the Stupp protocol with similar survival. Theses results need prospective confirmation. [ABSTRACT FROM AUTHOR]

Background. The American Academy of Neurology (AAN) does not recommend routine use of prophylactic antiepileptic drugs (pAEDs) in patients with newly diagnosed brain tumors. If used in the perioperative setting, discontinuation is suggested after the first post-operative week. It is unclear whether such recommendations are followed. Our objective was to compare our perioperative and long-term pAED use in glioma patients with AAN practice parameters. Methods. Retrospective chart review was performed on 578 glioma patients from 2006 to 2013. Seizures and AED use were assessed at surgery, 3 months postoperatively and death, last visit or 16 months postoperatively. Patients were divided into three groups at surgery: seizure-free with pAED, seizure-free without pAED, and seizure patients. Long-term pAED use was defined as continued use at 3 months postsurgery without seizures. pAEDs efficacy, factors influencing its use, and survival were examined. Results. Out of 578 patients identified, 330 (57.1%) were seizure-naïve preoperatively. There were no significant differences in age, histology, tumor location or resection status between seizure-free populations with and without prophylaxis. Of 330 seizure-naïve patients, 205 (62.1%) received pAEDs at surgery. Ninety-six (46.9%) of those patients were still on pAEDs 3 months postsurgery (median use = 58 days). Rate of long-term prophylaxis use decreased by 13.5% over 6 years (70.3% in 2006; 56.8% in 2012). Phenytoin was preferred in 2006 (98.2%) with increasing use of levetiracetam over 6 years (44.6% in 2012). The only predictive factor for pAED use was complete resection (P = .0069). First seizure prevalence was similar in both seizure-free populations (P = .91). The seizure population had more men (P = .007), younger patients (P < .0001), lower-grade gliomas (P = .0003) and survived longer (P = .001) compared with seizure-free populations. Conclusions. In our center, long-term prophylactic AED use is high, deviating from current AAN Guidelines. Corrective measures are warranted. [ABSTRACT FROM AUTHOR]