Zhu Xiaokuan, Lu Yao, Lu Shun
Department of Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China.
AstraZeneca China, Shanghai 201200, China.
Cancers (Basel). 2022 Dec 12;14(24):6122. doi: 10.3390/cancers14246122.
Non-small cell lung cancer (NSCLC) is increasingly being treated with targeted therapies. Savolitinib (Orpathys) is highly selective mesenchymal epithelial transition (MET)-tyrosine kinase inhibitor (TKI), which is conditionally approved in China for advanced NSCLC with exon 14 skipping mutations (ex14). This article summarizes the clinical development of savolitinib, as a monotherapy in NSCLC with ex14 mutation and in combination with epidermal growth factor receptor () inhibitor in post EGFR-TKI resistance NSCLC due to -based acquired resistance. Preclinical models demonstrated anti-tumor activities in -driven cancer cell line and xenograft tumor models. The Phase Ia/Ib study established an optimized, recommended phase II dose in Chinese NSCLC patients, while TATTON study of savolitinib plus osimertinib in patients with mutant, -amplified and TKI-progressed NSCLC showed beneficial efficacy with acceptable safety profile. In a pivotal phase II study, Chinese patients with pulmonary sarcomatoid carcinoma, brain metastasis and other NSCLC subtype positive for ex14 mutation showed notable responses and acceptable safety profile with savolitinib. Currently, results from ongoing clinical trials are eagerly anticipated to confirm the efficacious and safety benefits of savolitinib as monotherapy and in combination with EGFR-TKI in acquired resistance setting in advanced NSCLC and its subtypes with alterations.
非小细胞肺癌(NSCLC)越来越多地采用靶向治疗。赛沃替尼(Orpathys)是一种高度选择性的间充质上皮转化(MET)-酪氨酸激酶抑制剂(TKI),在中国有条件获批用于治疗具有外显子14跳跃突变(ex14)的晚期NSCLC。本文总结了赛沃替尼作为单药治疗具有ex14突变的NSCLC,以及在因EGFR-TKI获得性耐药导致的EGFR-TKI耐药后的NSCLC中与表皮生长因子受体(EGFR)抑制剂联合使用的临床研究进展。临床前模型在EGFR驱动的癌细胞系和异种移植肿瘤模型中显示出抗肿瘤活性。I期a/Ib期研究确定了中国NSCLC患者的优化推荐II期剂量,而赛沃替尼联合奥希替尼治疗EGFR突变、MET扩增且TKI治疗进展的NSCLC患者的TATTON研究显示出有益的疗效和可接受的安全性。在一项关键的II期研究中,中国患有肺肉瘤样癌、脑转移以及其他ex14突变阳性NSCLC亚型的患者接受赛沃替尼治疗后显示出显著疗效和可接受的安全性。目前,人们急切期待正在进行的临床试验结果,以证实赛沃替尼作为单药治疗以及与EGFR-TKI联合用于晚期NSCLC及其具有MET改变的亚型的获得性耐药情况时的有效性和安全性。