Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan.
Department of Respiratory Medicine, Okayama University Hospital, Okayama, Japan.
Cancer Sci. 2021 Apr;112(4):1556-1566. doi: 10.1111/cas.14826. Epub 2021 Feb 24.
MET mutations leading to exon 14 skipping (METΔex14) are strong molecular drivers for non-small-cell lung cancer (NSCLC). Capmatinib is a highly potent, selective oral MET inhibitor that showed clinically meaningful efficacy and a manageable safety profile in a global phase II study (GEOMETRY mono-1, NCT02414139) in patients with advanced METΔex14-mutated/MET-amplified NSCLC. We report results of preplanned analyses of 45 Japanese patients according to MET status (METΔex14-mutated or MET-amplified) and line of therapy (first- [1L] or second-/third-line [2/3L]). The starting dose was 400 mg twice daily. The primary endpoint was the objective response rate (ORR) assessed by a blinded independent review committee. A key secondary endpoint was duration of response (DOR). Among METΔex14-mutated patients, in the 1L group, one patient achieved partial response (DOR of 4.24 months) and the other had stable disease. In the 2/3L group, the ORR was 36.4% (95% confidence interval [CI] 10.9%-69.2%), median DOR was not evaluable, and progression-free survival was 4.70 months. One patient (2/3L group) showed partial resolution of brain lesions per independent neuroradiologist review. In MET-amplified patients with a MET gene copy number of ≥10, the ORR was 100% (2/2 patients) in the 1L group and 45.5% (5/11 patients) in the 2/3L group, with DOR of 8.2 and 8.3 months, respectively. Common treatment-related adverse events among the 45 Japanese patients were blood creatinine increased (53.3%), nausea (35.6%), and oedema peripheral (31.1%); most were grade 1/2 severity. In conclusion, capmatinib was effective and well tolerated by Japanese patients with METΔex14/MET-amplified NSCLC, consistent with the overall population.
MET 突变导致外显子 14 跳跃(METΔex14)是非小细胞肺癌(NSCLC)的强烈分子驱动因素。卡马替尼是一种高效、选择性的口服 MET 抑制剂,在全球 II 期研究(GEOMETRY mono-1,NCT02414139)中,对晚期 METΔex14 突变/MET 扩增 NSCLC 患者显示出有临床意义的疗效和可管理的安全性。我们报告了根据 MET 状态(METΔex14 突变或 MET 扩增)和治疗线(一线 [1L] 或二线/三线 [2/3L])对 45 名日本患者进行的预先计划分析结果。起始剂量为 400mg,每日两次。主要终点是由盲法独立审查委员会评估的客观缓解率(ORR)。关键次要终点是缓解持续时间(DOR)。在 METΔex14 突变患者中,在 1L 组中,1 名患者达到部分缓解(DOR 为 4.24 个月),另 1 名患者病情稳定。在 2/3L 组中,ORR 为 36.4%(95%置信区间 [CI] 10.9%-69.2%),中位 DOR 不可评估,无进展生存期为 4.70 个月。1 名患者(2/3L 组)经独立神经放射学家评估显示脑转移瘤部分缓解。在 MET 扩增患者中,MET 基因拷贝数≥10 的患者,1L 组的 ORR 为 100%(2/2 例),2/3L 组的 ORR 为 45.5%(5/11 例),DOR 分别为 8.2 和 8.3 个月。45 名日本患者中常见的治疗相关不良事件为血肌酐升高(53.3%)、恶心(35.6%)和外周水肿(31.1%);大多数为 1/2 级严重程度。总之,卡马替尼对日本 METΔex14/MET 扩增 NSCLC 患者有效且耐受良好,与总体人群一致。