Successful treatment with sintilimab plus anlotinib for SMARCA4-deficient non-small cell lung cancer withMET exon 14 skipping: a case report.

SMARCA4-deficient non-small-cell lung cancer (SD-NSCLC) is a rare and highly aggressive epithelial tumor that originates in the lungs. SD-NSCLCs are more prevalent among male smokers, lacks mutations of the mesenchymal-epithelial transition g (MET) gene, and does not have an established treatment plan. Herein, we present a unique case of an SD-NSCLC, an adenocarcinoma with a MET14 skipping mutation, in the left upper lung lobe which was classified as cT4N3M1a stage IVa. Next-generation sequencing revealed a D1010H skip mutation in exon 14 of MET, and immunohistochemistry indicated a programmed death ligand 1 expression level of 90%. Owing to financial constraints and concerns regarding chemotherapy, the patient declined MET inhibitor-targeted therapy and chemotherapy. Instead, the patient received sintilimab and anlotinib. Following two treatment cycles, a notable reduction in the lesions in the left upper lobe and a significant decrease in lung metastases were observed, and the patient has attained a progression free survival of >2 years. This case represents the initial documentation of SD-NSCLC featuring MET14 skipping mutations and its effective management with programmed death protein 1 inhibitors, in conjunction with anti-angiogenic agents. We believe that the combination of sintilimab and anlotinib can be a viable therapeutic approach for the treatment of SD-NSCLCs.