Tepotinib in patients with NSCLC harbouring MET exon 14 skipping: Japanese subset analysis from the Phase II VISION study

Jpn J Clin Oncol. 2021 Aug 1;51(8):1261-1268. doi: 10.1093/jjco/hyab072.

Abstract

Background: MET exon 14 skipping is an oncogenic driver occurring in 3-4% of non-small cell lung cancer (NSCLC). The MET inhibitor tepotinib has demonstrated clinical efficacy in patients with MET exon 14 skipping NSCLC. Here, we present data from Japanese patients in the Phase II VISION study, evaluating the efficacy and safety of tepotinib.

Methods: In the open-label, single-arm, Phase II VISION study, patients with advanced/metastatic NSCLC with MET exon 14 skipping received oral tepotinib 500 mg once daily. The primary endpoint was objective response by independent review. Subgroup analyses of Japanese patients were preplanned.

Results: As of 1 January 2020, 19 Japanese patients received tepotinib and were evaluated for safety, 15 of whom had ≥9 months' follow-up and were also analysed for efficacy. By independent review, objective response rate (ORR) was 60.0% (95% confidence interval [CI]: 32.3, 83.7), median duration of response was not reached (95% CI: 6.9, not estimable [ne]), and progression-free survival was 11.0 months (95% CI: 1.4, ne). ORR in patients with MET exon 14 skipping identified by liquid biopsy (n = 8) was 87.5% (95% CI: 47.3, 99.7), and by tissue biopsy (n = 12) was 50.0% (95% CI: 21.1, 78.9). Patients' quality of life was maintained with tepotinib treatment. Among patients evaluated for safety, the most common treatment-related adverse events (any grade) were blood creatinine increase and peripheral oedema (12 and nine patients, respectively).

Conclusions: Tepotinib demonstrated robust and durable clinical efficacy in Japanese patients with advanced NSCLC harbouring MET exon 14 skipping, identified by either liquid or tissue biopsy. The main adverse events, blood creatinine increase and peripheral oedema, were manageable.

Keywords: carcinoma; liquid biopsy; non-small-cell lung; protein kinase inhibitors; proto-oncogene proteins c-Met; tepotinib.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / radiation effects
  • Carcinoma, Non-Small-Cell Lung* / drug therapy
  • Carcinoma, Non-Small-Cell Lung* / genetics
  • Clinical Trials, Phase II as Topic
  • Exons / genetics
  • Female
  • Humans
  • Japan
  • Lung Neoplasms* / drug therapy
  • Lung Neoplasms* / genetics
  • Male
  • Middle Aged
  • Mutation
  • Piperidines*
  • Protein Kinase Inhibitors / adverse effects
  • Proto-Oncogene Mas
  • Proto-Oncogene Proteins c-met* / genetics
  • Pyridazines*
  • Pyrimidines*
  • Quality of Life
  • Retrospective Studies

Substances

  • Antineoplastic Agents
  • MAS1 protein, human
  • Piperidines
  • Protein Kinase Inhibitors
  • Proto-Oncogene Mas
  • Pyridazines
  • Pyrimidines
  • tepotinib
  • MET protein, human
  • Proto-Oncogene Proteins c-met