Safety of tepotinib in patients with MET exon 14 skipping NSCLC and recommendations for management Journal Article


Authors: Veillon, R.; Sakai, H.; Le, X.; Felip, E.; Cortot, A. B.; Smit, E. F.; Park, K.; Griesinger, F.; Britschgi, C.; Wu, Y. L.; Melosky, B.; Baijal, S.; de Castro, G. D. Jr; Sedova, M.; Berghoff, K.; Otto, G.; Paik, P. K.
Article Title: Safety of tepotinib in patients with MET exon 14 skipping NSCLC and recommendations for management
Abstract: Introduction: The MET inhibitor tepotinib demonstrated durable clinical activity in patients with advanced MET exon 14 (METex14) skipping NSCLC. We report detailed analyses of adverse events of clinical interest (AECIs) in VISION, including edema, a class effect of MET inhibitors. Patients and Methods: Incidence, management, and time to first onset/resolution were analyzed for all-cause AECIs, according to composite categories (edema, hypoalbuminemia, creatinine increase, and ALT/AST increase) or individual preferred terms (pleural effusion, nausea, diarrhea, and vomiting), for patients with METex14 skipping NSCLC in the phase II VISION trial. Results: Of 255 patients analyzed (median age: 72 years), edema, the most common AECI, was reported in 69.8% (grade 3, 9.4%; grade 4, 0%). Median time to first edema onset was 7.9 weeks (range: 0.1-58.3). Edema was manageable with supportive measures, dose reduction (18.8%), and/or treatment interruption (23.1%), and rarely prompted discontinuation (4.3%). Other AECIs were also manageable and predominantly mild/moderate: hypoalbuminemia, 23.9% (grade 3, 5.5%); pleural effusion, 13.3% (grade ≥ 3, 5.1%); creatinine increase, 25.9% (grade 3, 0.4%); nausea, 26.7% (grade 3, 0.8%), diarrhea, 26.3% (grade 3, 0.4%), vomiting 12.9% (grade 3, 1.2%), and ALT/AST increase, 12.2% (grade ≥ 3, 3.1%). GI AEs typically occurred early and resolved in the first weeks. Conclusion: Tepotinib was well tolerated in the largest trial of a MET inhibitor in METex14 skipping NSCLC. The most frequent AEs were largely mild/moderate and manageable with supportive measures and/or dose reduction/interruption, and caused few withdrawals in this elderly population. © 2022 The Authors
Keywords: aged; exon; genetics; mutation; exons; diarrhea; edema; protein kinase inhibitor; nausea; vomiting; carcinoma, non-small-cell lung; lung neoplasms; creatinine; pyrimidines; protein kinase inhibitors; lung tumor; hypoalbuminemia; pleura effusion; piperidines; pyrimidine derivative; scatter factor receptor; non small cell lung cancer; adverse event; proto-oncogene proteins c-met; piperidine derivative; pleural effusion; met inhibitor; humans; human; non–small cell lung cancer; tepotinib; pyridazine derivative; pyridazines
Journal Title: Clinical Lung Cancer
Volume: 23
Issue: 4
ISSN: 1525-7304
Publisher: Elsevier Inc.  
Date Published: 2022-06-01
Start Page: 320
End Page: 332
Language: English
DOI: 10.1016/j.cllc.2022.03.002
PUBMED: 35466070
PROVIDER: scopus
PMCID: PMC10068910
DOI/URL:
Notes: Article -- Export Date: 1 July 2022 -- Source: Scopus
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. Paul K Paik
    255 Paik