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来自 II 期 VISION 研究的 MET 外显子 14 跳跃 NSCLC 日本患者中 tepotinib 的长期经验。

Long-term experience with tepotinib in Japanese patients with MET exon 14 skipping NSCLC from the Phase II VISION study.

机构信息

Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.

Department of Thoracic Oncology, Kanagawa Cancer Center, Yokohama, Japan.

出版信息

Cancer Sci. 2024 Apr;115(4):1296-1305. doi: 10.1111/cas.16107. Epub 2024 Feb 25.

Abstract

Tepotinib is a highly selective MET tyrosine kinase inhibitor (TKI) that has demonstrated robust and durable clinical activity in patients with MET exon 14 (METex14) skipping non-small-cell lung cancer (NSCLC). In the Phase II VISION study, patients received oral tepotinib 500 mg once daily. The primary endpoint was an objective response by an independent review committee (IRC) according to RECIST v1.1 criteria. The secondary endpoints included duration of response (DOR), progression-free survival (PFS), overall survival (OS), and safety. Here we report the analysis of the efficacy and safety of tepotinib in all Japanese patients with advanced METex14 skipping NSCLC from VISION (n = 38) with >18 months' follow-up. The median age of the Japanese patients was 73 years (range 63-88), 39.5% of patients were ≥75 years old, 68.4% were male, 55.3% had a history of smoking, 76.3% had adenocarcinoma, and 10.5% of patients had known brain metastases at baseline. Overall, the objective response rate (ORR) was 60.5% (95% confidence interval (CI): 43.4, 76.0) with a median DOR of 18.5 months (95% CI: 8.3, not estimable). ORR in treatment-naïve patients (n = 18) was 77.8% (95% CI: 52.4, 93.6), and in patients aged ≥75 years (n = 15), ORR was 73.3% (95% CI: 44.9, 92.2). The most common treatment-related adverse event (AE) with any grade was blood creatinine increase (65.8%), which resolved following tepotinib discontinuation. Other common treatment-related AEs were peripheral edema (60.5%), hypoalbuminemia (34.2%), diarrhea (28.9%), and nausea (15.8%). In summary, tepotinib demonstrated robust and durable clinical activity irrespective of age or therapy line, with a manageable safety profile in Japanese patients with METex14 skipping NSCLC enrolled in VISION.

摘要

特泊替尼是一种高度选择性的 MET 酪氨酸激酶抑制剂(TKI),在 MET 外显子 14(METex14)跳跃非小细胞肺癌(NSCLC)患者中显示出强大和持久的临床活性。在 II 期 VISION 研究中,患者每日口服特泊替尼 500mg。主要终点是根据 RECIST v1.1 标准由独立审查委员会(IRC)评估的客观缓解率。次要终点包括缓解持续时间(DOR)、无进展生存期(PFS)、总生存期(OS)和安全性。在此,我们报告了来自 VISION 的所有日本晚期 METex14 跳跃 NSCLC 患者(n=38)的疗效和安全性分析,这些患者的随访时间超过 18 个月。日本患者的中位年龄为 73 岁(范围 63-88),39.5%的患者年龄≥75 岁,68.4%为男性,55.3%有吸烟史,76.3%为腺癌,10.5%的患者基线时有已知的脑转移。总体而言,客观缓解率(ORR)为 60.5%(95%置信区间(CI):43.4,76.0),中位 DOR 为 18.5 个月(95%CI:8.3,不可估计)。治疗初治患者(n=18)的 ORR 为 77.8%(95%CI:52.4,93.6),年龄≥75 岁的患者(n=15)的 ORR 为 73.3%(95%CI:44.9,92.2)。任何级别最常见的与治疗相关的不良事件(AE)是血肌酐升高(65.8%),在停用特泊替尼后得到缓解。其他常见的与治疗相关的 AE 包括外周水肿(60.5%)、低白蛋白血症(34.2%)、腹泻(28.9%)和恶心(15.8%)。总之,特泊替尼在 VISION 中入组的日本 METex14 跳跃 NSCLC 患者中显示出强大和持久的临床活性,无论年龄或治疗线如何,且具有可管理的安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92c0/11006997/c0b5f56051be/CAS-115-1296-g002.jpg

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