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Tepotinib Therapy for Advanced MET Exon 14 Skipping NSCLC With Non-Dialysis End-Stage Renal Disease: A Case Report

Susumu Yamazaki1, Yoshiaki Nagai1, Hitomi Watanabe1

  • 1Department of Respiratory Medicine Saitama Medical University Hospital Saitama Japan.

Respirology Case Reports
|February 19, 2026
PubMed

Insights

Tepotinib shows promise for advanced MET exon 14 skipping non-small cell lung cancer (NSCLC) in patients with end-stage renal disease (ESRD). Monitoring cystatin C alongside creatinine aids safe treatment, even with dose adjustments.

Area of Science:

  • Oncology
  • Pharmacology
  • Nephrology

Background:

  • Tepotinib is an oral MET tyrosine kinase inhibitor for advanced MET exon 14 skipping NSCLC.
  • Dosing guidelines for tepotinib in severe renal impairment, including end-stage renal disease (ESRD), are limited.
  • MET exon 14 skipping mutations are a driver in a subset of non-small cell lung cancer (NSCLC) patients.

Purpose of the Study:

  • To report a case of successful tepotinib treatment in a patient with ESRD and advanced MET exon 14 skipping NSCLC.
  • To investigate the renal safety profile and optimal dosing of tepotinib in a patient with ESRD.
  • To evaluate the utility of cystatin C as a biomarker in managing tepotinib therapy in renal dysfunction.

Main Methods:

  • A case report of a patient with ESRD and advanced MET exon 14 skipping NSCLC treated with tepotinib.
  • Monitoring of serum creatinine and cystatin C during tepotinib therapy.
  • Dose adjustment of tepotinib based on renal function and clinical response.

Main Results:

  • Successful treatment with tepotinib leading to a partial tumor response in a patient with ESRD.
  • Transient increase in serum creatinine, with stable cystatin C, suggesting pseudo-acute kidney injury.
  • Tepotinib was safely resumed at a reduced dose without further renal deterioration.

Conclusions:

  • Tepotinib therapy is feasible in carefully selected ESRD patients with MET exon 14 skipping NSCLC.
  • Cystatin C is a valuable complementary biomarker for guiding tepotinib treatment decisions in renal impairment.
  • This case supports cautious use of tepotinib in ESRD, with vigilant monitoring and potential dose modification.
Keywords:
MET exon 14 skippingTepotinibcreatininecystatin Cend‐stage renal disease (ESRD)estimated glomerular filtration rate (eGFR)lung cancermesenchymal–epithelial transition factor (MET)tyrosine kinase inhibitor (TKI)

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