MET Targeted Therapy for NSCLC - Episode 4

The Availability of MET Inhibitors for NSCLC

March 23, 2020

Edward B. Garon, MD:Capmatinib is not the only drug that’s being explored in this space. One other drug that has received a favorable review as well by the FDA is tepotinib. Tepotinib is a similar drug also directed againstMETthat has been evaluated in previously treated patients withMETexon 14 skipping mutation. Tepotinib also has received breakthrough designation by the FDA. It clearly would be a great event for patients should either of these drugs be approved for patients withMETexon 14 skipping.

Particularly for patients who have received prior therapy for non—small cell lung cancer, I recognize we have lack of comparative data compared with docetaxel-based therapy, which I would say is the standard therapy for previously treated patients in this setting. In the absence of comparative data, I still would argue that most of us would, based on the data we’ve seen for both efficacy and tolerability for both capmatinib and tepotinib, prefer a MET inhibitor in this setting for this population of patients as opposed to docetaxel-based therapy.

I would say that the approval of METinhibitors for patients withMETexon 14 skipping is not paradigm shifting in that we now have several drugs that are already approved for targeted populations in the setting of advanced non—small cell lung cancer.

What I would say instead is that it is a continuation of the advances we have seen in molecular medicine. That, in many respects, is the fruits of this long labor of trying to subdivide what traditionally is a grab bag of different diagnoses. On some level, just the namenon—small cell lung cancerindicates that you’re not indicating what the disease is. You’re just simply indicating what it’s not, which is that it’s in the lung and not small cell lung cancer.

This approval forMETexon 14 skipping would be a continuation of this promise that if you figure out what is driving the tumor and look hard, and you develop good drugs that are affective against those subsets, you will be able to move the disease forward. That’s something we have seen. One thing that’s particularly exciting about this target is that it is not particularly rare.

NTRK, which does have approval in a whole host of histologies, including lung cancer, is very exciting. But it doesn’t affect a tremendous number of patients in lung cancer specifically, although it does if you look across histologies. Some of the other targets being looked at also are quite rare. But that is not true forMETexon 14 skipping. It really does have a presence in 3% or 4% of non—small cell lung cancer. Again, when one looks at the number of patients who have non–small cell lung cancer, it is a really significant number of people.

Transcript edited for clarity.