Treatment Sequencing of Tepotinib in Patients With MET Exon 14 Skipping NSCLC: The VISION Study

Tepotinib is a mesenchymal epithelial transition (MET) factor tyrosine kinase inhibitor approved for METex14 skipping NSCLC. Results from the VISION study that evaluated pre/post-tepotinib treatment sequencing of IO, chemotherapy (CT), and MET inhibitors (METi; post only) were presented at the 2023 North America Conference on Lung Cancer. These results were also previously presented at the European Lung Cancer Congress 2023.

Patients with advanced/metastatic METex14 skipping NSCLC receiving tepotinib 500 mg (450 mg active moiety) once daily were included in the study. The primary end point was objective response rate (ORR). Among 313 patients, the median age was 72 years, 164 were first line, and 149 were second line.

Results showed that among second- and later-line patients, the most common first-line regimen prior to enrolling in VISION was platinum-CT without IO (58%), followed by IO monotherapy (23%) and IO-CT (13%). Across all prior first-line regimens, the median duration of treatment was 4 months, with an ORR of 24.8%, median duration of response (mDOR) of 6 months, and median PFS (mPFS) of 4 months. In contrast, first-line outcomes with tepotinib were greatly improved, with an ORR of 56.1%, mDOR of 46.4 months, and mPFS of 12.6 months.

Overall, the researchers found that 265 (84.7%) patients discontinued tepotinib and 124 (46.8%) received subsequent treatment, of whom 48 received subsequent METi. The best overall response (BOR) across all subsequent METi was three partial responses and 11 with stable disease. The longest mDOR and mPFS were 4.0 and 2.5 months, respectively.

The researchers concluded that “robust and durable efficacy, particularly in [the first line], support early use of tepotinib in the treatment sequence. Almost half of this elderly population received subsequent treatment, higher than the 20% to 30% reported for the [first-line] CT/IO IPSOS trial in elderly patients.”

Source: Griesinger F, Garassino MC, Felip E, et al. Treatment sequencing in the VISION study of tepotinib in patients with MET exon 14 (METex14) skipping NSCLC. Abstract of a poster presented at the 2023 North America Conference on Lung Cancer; December 1-3, 2023; Chicago, Illinois.