Evolving roles of MET as a therapeutic target in NSCLC and beyond

Jii Bum Lee1, Joo Sung Shim2, Byoung Chul Cho3

  • 1Division of Medical Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea.

Insights

Targeting the proto-oncogene MET is crucial for treating various solid cancers. Emerging therapies like MET tyrosine-kinase inhibitors, antibodies, and antibody-drug conjugates show promise for MET-altered tumors.

Area of Science:

  • Oncology
  • Molecular Biology
  • Drug Development

Background:

  • Proto-oncogene MET alterations drive tumor development, invasion, and metastasis in solid cancers.
  • Actionable MET alterations include MET exon 14 skipping (METex14) mutations, amplification, overexpression, and fusions, with varying incidences across tumor types.
  • Acquired MET amplification/overexpression is common and has significant clinical implications, contrasting with rarer de novo alterations.

Purpose of the Study:

  • To review the rationale for targeting MET alterations in solid tumors.
  • To summarize the clinical efficacy and toxicity of approved and emerging MET-targeted therapies.
  • To discuss the evolving treatment paradigms for MET-altered solid tumors.

Main Methods:

  • Literature review of clinical trials and studies on MET-targeted agents.
  • Analysis of efficacy and safety data for MET tyrosine-kinase inhibitors (TKIs), antibodies, and antibody-drug conjugates (ADCs).
  • Examination of the incidence and clinical relevance of different MET alterations in various solid cancers.

Main Results:

  • METex14 mutations are a distinct oncogenic driver in non-small-cell lung cancer (NSCLC).
  • Approved MET TKIs (capmatinib, tepotinib, savolitinib) treat advanced METex14-mutant NSCLC.
  • Emerging data support MET TKIs, anti-MET antibodies, and MET-directed ADCs for MET amplification/overexpression in NSCLC and other tumors, with recent FDA approval for telisotuzumab vedotin in NSCLC.

Conclusions:

  • Targeting MET alterations is a rapidly evolving field with diverse therapeutic strategies.
  • Understanding the efficacy and toxicity profiles of various MET-targeted agents is crucial for clinical practice.
  • MET-targeted therapies, including TKIs, antibodies, and ADCs, offer new treatment options for patients with MET-altered solid tumors.

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