(049) Assess the applicability of capmatinib and tepotinib to real-world patients in Taiwan with MET mutations

Background: Capmatinib and tepotinib, selective inhibitors of the MET receptor, have begun to make an impact on non-small cell lung cancer (NSCLC). However, there is limited available data regarding the real-world application of capmatinib and tepotinib treatments, particularly in terms of their generalizability to patients with MET mutations.

Objectives: To assess the applicability of capmatinib or tepotinib among new users in Taiwan, we examined their generalizability based on the baseline characteristics outlined according to Geometry Mono-1 and VISION pivotal phase 2 clinical trials.

Methods: We conducted a retrospective study by analyzing electronic health records from multiple medical institutions, ranging from local hospitals to medical centers. This study included patients who had newly received treatment with either capmatinib or tepotinib for NSCLC between August 2020 and June 2023. We collected and compared the characteristics of real-world users to those of trial patients, including (1) MET mutation type, (2) cancer stage, (3) treatment line, (4) whether other chemotherapy treatments were administered concurrently, and (5) the presence of brain metastases. We followed up with each patient until disease progression, death, or the end of December 31, 2023, whichever came first. Additionally, we applied the Kaplan-Meier method to estimate the median progression-free survival (PFS).

Results: A total of 33 NSCLC patients were evaluated in our study, comprising 27 (81.8%) new users of capmatinib and 6 (18.2%) new users of tepotinib. The median age of the patients was 62 years (range: 45 to 90 years), with 18 (54.5%) of them being male. We found that 18 (54.5%) patients were detected with MET exon 14 skipping mutation, while 15 (45.5%) patients exhibited MET amplification.Most NSCLC cases were stage IV, with only two classified as stage III B. All patients received capmatinib or tepotinib as first-line treatment and underwent combined chemotherapy. Among them, 9 (27.2%) patients had brain metastases. Additionally, the median progression-free survival (PFS) was 12.1 months (7.8 - non-reach).

Conclusions: Our study revealed that following treatment with capmatinib or tepotinib, the median PFS was longer compared to that observed in phase 2 clinical trials. However, in our real-world patients, aside from using one of these two drugs as first-line treatment, they also receive combined chemotherapy. Further follow-up studies are still needed to confirm our findings.