University of Colorado Cancer Center, Aurora, CO.
Sheba Medical Center, Ramat Gan, Israel.
J Clin Oncol. 2024 Sep 1;42(25):3000-3011. doi: 10.1200/JCO.24.00720. Epub 2024 Jun 6.
Telisotuzumab vedotin (Teliso-V) is a c-Met-directed antibody-drug conjugate with a monomethyl auristatin E cytotoxic payload. The phase II LUMINOSITY trial (ClinicalTrials.gov identifier: NCT03539536) aimed to identify the optimal c-Met protein-overexpressing non-small cell lung cancer (NSCLC) population for treatment with Teliso-V (stage I) and expand the selected group for efficacy evaluation (stage II). Stage II enrolled patients with nonsquamous epidermal growth factor receptor ()-wildtype NSCLC.
Eligible patients had locally advanced/metastatic c-Met protein-overexpressing NSCLC and ≤2 previous lines of therapy (including ≤1 line of systemic chemotherapy). c-Met protein overexpression in nonsquamous -wildtype NSCLC was defined as ≥25% tumor cells with 3+ staining (high [≥50% 3+]; intermediate [≥25%-<50%]). Teliso-V was administered at 1.9 mg/kg once every 2 weeks. The primary end point was overall response rate (ORR) by independent central review.
In total, 172 patients with nonsquamous -wildtype NSCLC received Teliso-V in stages I and II. ORR was 28.6% (95% CI, 21.7 to 36.2; c-Met high, 34.6% [95% CI, 24.2 to 46.2]; c-Met intermediate, 22.9% [95% CI, 14.4 to 33.4]). The median duration of response was 8.3 months (95% CI, 5.6 to 11.3; c-Met high, 9.0 [95% CI, 4.2 to 13.0]; c-Met intermediate: 7.2 [95% CI, 5.3 to 11.5]). The median overall survival was 14.5 months (95% CI, 9.9 to 16.6; c-Met high, 14.6 [95% CI, 9.2 to 25.6]; c-Met intermediate, 14.2 [95% CI, 9.6 to 16.6]). The median progression-free survival was 5.7 months (95% CI, 4.6 to 6.9; c-Met high, 5.5 [95% CI, 4.1 to 8.3]; c-Met intermediate: 6.0 [95% CI, 4.5 to 8.1]). Most common any-grade treatment-related adverse events (AEs) were peripheral sensory neuropathy (30%), peripheral edema (16%), and fatigue (14%); the most common grade ≥3 AE was peripheral sensory neuropathy (7%).
Teliso-V was associated with durable responses in c-Met protein-overexpressing nonsquamous -wildtype NSCLC, especially in those with high c-Met. AEs were generally manageable.
Telisotuzumab vedotin(Teliso-V)是一种针对 c-Met 的抗体药物偶联物,具有单甲基奥瑞他汀 E 细胞毒性有效载荷。LUMINOSITY 二期临床试验(ClinicalTrials.gov 标识符:NCT03539536)旨在确定治疗 Teliso-V 的最佳 c-Met 蛋白过表达非小细胞肺癌(NSCLC)人群(I 期),并扩大选定人群进行疗效评估(II 期)。II 期纳入了非鳞状表皮生长因子受体()-野生型 NSCLC 患者。
符合条件的患者患有局部晚期/转移性 c-Met 蛋白过表达 NSCLC,且接受过≤2 线治疗(包括≤1 线系统化疗)。非鳞状 -野生型 NSCLC 中的 c-Met 蛋白过表达定义为≥25%肿瘤细胞有 3+染色(高[≥50%3+];中[≥25%-<50%])。Teliso-V 以 1.9mg/kg 的剂量每 2 周静脉输注一次。主要终点是独立中心审查的总缓解率(ORR)。
共 172 例非鳞状 -野生型 NSCLC 患者在 I 期和 II 期接受了 Teliso-V 治疗。ORR 为 28.6%(95%CI,21.7 至 36.2;c-Met 高,34.6%[95%CI,24.2 至 46.2];c-Met 中,22.9%[95%CI,14.4 至 33.4])。中位缓解持续时间为 8.3 个月(95%CI,5.6 至 11.3;c-Met 高,9.0[95%CI,4.2 至 13.0];c-Met 中:7.2[95%CI,5.3 至 11.5])。中位总生存期为 14.5 个月(95%CI,9.9 至 16.6;c-Met 高,14.6[95%CI,9.2 至 25.6];c-Met 中,14.2[95%CI,9.6 至 16.6])。中位无进展生存期为 5.7 个月(95%CI,4.6 至 6.9;c-Met 高,5.5[95%CI,4.1 至 8.3];c-Met 中:6.0[95%CI,4.5 至 8.1])。最常见的任何级别治疗相关不良事件(AE)是周围感觉神经病变(30%)、周围水肿(16%)和疲劳(14%);最常见的≥3 级 AE 是周围感觉神经病变(7%)。
Teliso-V 与 c-Met 蛋白过表达的非鳞状 -野生型 NSCLC 患者的持久缓解相关,尤其是 c-Met 高表达的患者。AE 通常是可控的。