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GEOMETRY Study Confirms Importance of Testing for METex14 Alterations in Advanced NSCLC

Jurgen Wolf, MD
Published Online:6:30 PM, Fri July 12, 2019

Jurgen Wolf, MD, a medical oncologist at the University Hospital of Cologne in Köln, Germany, discusses the importance of broad genomic testing to identify alterations in patients with advanced non–small cell lung cancer (NSCLC). By identifying molecular alterations and driver mutations early on, patients can receive matched targeted therapies at a time in the course of disease when the treatments would have the greatest impact.

Data from the phase II GEOMETRY Mono-1 trial, presented at the 2019 ASCO Annual Meeting, demonstrated promising response rates with capmatinib (INC280) in patients with METex14-altered advanced NSCLC. The findings suggest that by identifying patients early on with the METex14 alteration, more patients could benefit from this agent.

High response rates noted in the frontline setting with capmatinib demonstrate a clear need for identifying METex14 alterations prior to initial therapy. However, a major challenge in the field remains incorporating genomic testing approaches into community practice, Wolf says.

The GEOMETRY trial examined capmatinib across a number of cohorts in the first-, second-, and third-lines for patients with METex14-altered advanced NSCLC. Cohort 4, which looked at capmatinib in the second- and third-lines, showed an objective response rate (ORR) of 40.6% by independent review, while in cohort 5, patients treated in the frontline setting had an ORR of 67.9%; the disease control rates were 78.3% and 96.4%, respectively.

Although deep responses were observed in both groups of patients, the response was particularly dramatic in the frontline setting. Wolf concludes that identifying alterations in patients with NSCLC, such as METex14, prior to initial treatment could greatly impact outcomes for these patients.
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