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Capmatinib in Japanese patients with MET exon 14 skipping-mutated or MET-amplified advanced NSCLC: GEOMETRY mono-1
Takashi Seto1, Kadoaki Ohashi2, Shunichi Sugawara3
1Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan.
Abstract:
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.
Insights
Capmatinib demonstrated efficacy in Japanese patients with non-small-cell lung cancer (NSCLC) harboring MET exon 14 skipping mutations or MET amplification. The drug was well-tolerated, showing promising results across different lines of therapy.
Area of Science:
- Oncology
- Medical Genetics
- Pharmacology
Background:
- MET exon 14 skipping (METΔex14) mutations and MET amplification are key drivers in non-small-cell lung cancer (NSCLC).
- Capmatinib is an oral MET inhibitor evaluated for advanced NSCLC with these specific genetic alterations.
Purpose of the Study:
- To report preplanned analyses of capmatinib efficacy and safety in 45 Japanese patients with METΔex14-mutated or MET-amplified NSCLC.
- To evaluate outcomes based on MET status and line of therapy (first-line [1L] vs. second-/third-line [2/3L]).
Main Methods:
- A global phase II study (GEOMETRY mono-1) included 45 Japanese patients.
- Patients received capmatinib 400 mg twice daily.
- Primary endpoint: objective response rate (ORR) by blinded independent review; secondary endpoint: duration of response (DOR).
Main Results:
- In METΔex14-mutated NSCLC, ORR was 36.4% in 2/3L therapy with a median DOR not evaluable and progression-free survival of 4.70 months.
- In MET-amplified NSCLC (MET gene copy number ≥10), ORR was 100% in 1L and 45.5% in 2/3L, with DOR of 8.2 and 8.3 months, respectively.
- Common adverse events included increased blood creatinine, nausea, and peripheral edema, mostly grade 1/2.
Conclusions:
- Capmatinib showed clinical efficacy in Japanese patients with METΔex14-mutated or MET-amplified NSCLC.
- The safety profile was manageable and consistent with the overall study population.
- Capmatinib is an effective and well-tolerated treatment option for this NSCLC subgroup.
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