Safety of tepotinib in patients with MET exon 14 skipping NSCLC and recommendations for management
Veillon, Remi Sakai, Hiroshi Le, Xiuning Felip, Enriqueta Cortot, Alexis B Smit, Egbert F Park, Keunchil Griesinger, Frank Britschgi, Christian Wu, Yi-Long
Veillon, Remi
Sakai, Hiroshi
Le, Xiuning
Felip, Enriqueta
Cortot, Alexis B
Smit, Egbert F
Park, Keunchil
Griesinger, Frank
Britschgi, Christian
Wu, Yi-Long
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2022-03-17
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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.
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Veillon R, Sakai H, Le X, Felip E, Cortot AB, Smit EF, Park K, Griesinger F, Britschgi C, Wu YL, Melosky B, Baijal S, Jr GC, Sedova M, Berghoff K, Otto G, Paik PK. Safety of Tepotinib in Patients With MET Exon 14 Skipping NSCLC and Recommendations for Management. Clin Lung Cancer. 2022 Jun;23(4):320-332. doi: 10.1016/j.cllc.2022.03.002. Epub 2022 Mar 17
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