Savolitinib plus cetuximab in recurrent/metastatic head and neck squamous cell carcinoma with EGFR and MET amplification after cetuximab-based therapy: A case report

The limited availability of targetable genomic alterations in Recurrent/Metastatic Head and Neck Squamous Cell Carcinoma (R/M HNSCC) often results in suboptimal outcomes when utilizing targeted therapies. This case report describes a 57-year-old non-smoker male patient who was initially diagnosed with stage I (pT1cN0M0) tongue squamous cell carcinoma (AJCC 8th edition), characterized by EGFR overexpression. The combination therapy with TPEx regimen (Cetuximab, docetaxel, and cisplatin) led to a partial response. Over the following two years, the patient developed multiple metastatic lesions, including a lung lesion confirmed as metastatic squamous cell carcinoma harboring EGFR and MET co-amplification. Treatment with Savolitinib plus Cetuximab was associated with a reduction in metastatic lesions within two months, with a best response of partial response and a progression-free survival of 8.1 months. Unfortunately, the disease advanced, leading to liver metastasis and subsequent multi-organ failure. This case highlights that patients with MET amplification following progression on EGFR-targeted therapies may attain considerable clinical benefit from combination therapy with Savolitinib and Cetuximab, potentially overcoming MET-mediated resistance to EGFR inhibitors. These findings suggested that this combination may have clinical activity and supports further investigation in similar clinical scenarios.