Abstract 593P
Background
Multiple MET TKIs are approved or under regulatory review in Asia for treatment of advanced METex14 NSCLC. However, head-to-head studies are lacking. We conducted MAICs of tepotinib vs savolitinib, gumarontinib, or capmatinib in pts in Asia.
Methods
Pt-level data for pts enrolled in Asia in VISION (tepotinib, global trial; data cut-off: Nov 20, 2022) were reweighted to match the baseline characteristics of the overall populations of NCT02897479 (savolitinib, Asian trial) and GLORY (gumarontinib, Asian trial), and pts enrolled in Asia in GEOMETRY mono-1 Cohorts 4/5b (capmatinib, global trial). Pts were stratified by first-/second- or later-line (1L/2L+). Subgroup analyses evaluated VISION pts with METex14 in tissue biopsies (T+). ORR and PFS by IRC, and OS were compared.
Results
Compared with VISION pts overall (n=313), outcomes were similar in pts enrolled in Asia (n=107), or T+ pts in Asia (n=87). Before reweighting, T+ pts enrolled in Asia had an ORR of 67% (95% CI: 53, 80), median (m) PFS of 16.5 months (11.0, ne [not evaluable]), and mOS of 32.7 months (19.1, ne) in 1L (n=46), and ORR of 49% (34, 64), mPFS of 13.8 months (6.9, ne), and mOS of 23.9 months (19.3, ne) in 2L+ (n=41). After reweighting, PFS and OS appeared longer with tepotinib vs savolitinib and gumarontinib in 1L and 2L+ (Table). PFS also seemed longer with tepotinib vs capmatinib in 1L (tepotinib effective sample size [ESS]=5.6; capmatinib, n=3; mPFS: 49.7 [15.9, ne] vs 5.5 months [4.5, ne]) and 2L+ (tepotinib ESS=29.6; capmatinib, n=17; mPFS: 11.1 [5.6, ne] vs 5.0 months [4.1, ne]). Corresponding capmatinib OS data were not available. Improvements with tepotinib vs comparators were also seen in VISION pts overall and pts in Asia, regardless of T+ status. Table: 593P
1L | 2L+ | |||
Tepotinib weighted* | Savolitinib † | Tepotinib weighted* | Savolitinib † | |
n/ESS | 22.0 | 28 | 11.4 | 42 |
ORR, % (95% CI) | 67 (54, 81) | 54 (35, 73) | 39 (24, 54) | 53 (37, 68) |
mPFS, mo (95% CI) | 12.6 (10.8, ne) | 6.9 (5.5, 8.4) | 13.8 (11.0, ne) | 7.0 (4.3, 13.8) |
mOS, mo (95% CI) | 28.5 (22.7, ne) | 10.9 (8.2, 22.5) | 20.8 (17.7, ne) | 17.5 (10.9, 31.5) |
1L | 2L+ | |||
Tepotinib weighted* | Gumarontinib † | Tepotinib weighted* | Gumarontinib † | |
n/ESS | 29.3 | 46 | 14.1 | 38 |
ORR, % (95% CI) | 69 (56, 83) | 71 (56, 83) | 52 (37, 68) | 60 (44, 75) |
mPFS, mo (95% CI) | 22 (8.3, ne) | 11.8 (8.6, ne) | 11.1 (5.5, ne) | 7.6 (4.1, 9.7) |
mOS, mo (95% CI) | nr (13.8, ne) | nr (16.9, ne) | 36.4 (12.3, ne) | 16.2 (11.7, ne) |
nr, not reached.*T+ subgroup of pts enrolled in Asia. †Overall population of an Asian trial in T+ pts.
Conclusions
Based on available evidence (with limited capmatinib subgroup size), the MAICs show no clinically relevant differences in ORR and trends for longer PFS and/or OS with tepotinib vs savolitinib, gumarontinib, or capmatinib in pts in Asia in 1L and 2L+.
Clinical trial identification
CrossRef funder ID: 10.13039/100009945.
Editorial acknowledgement
Medical writing assistance was provided by Bhartendu K Srivastava, PhD, of Syneos Health, London, UK.
Legal entity responsible for the study
Merck Healthcare KGaA, Darmstadt, Germany Merck Healthcare KGaA.
Funding
Merck (CrossRef Funder ID: 10.13039/100009945).
Disclosure
Y. Wu: Financial Interests, Personal, Other, Institute grants and personal fees: AstraZeneca, Roche, Boehringer Ingelheim; Financial Interests, Personal, Speaker, Consultant, Advisor: BMS, MSD, Eili Lilly, Pfizer. T. Douglas, A. Hatswell: Financial Interests, Personal, Full or part-time Employment: Delta Hat Ltd. Y.A. Yao: Financial Interests, Personal, Full or part-time Employment: Merck Serono Co., Ltd., Beijing, China, an affiliate of Merck KGaA. H. Vioix: Financial Interests, Personal, Full or part-time Employment: Merck. All other authors have declared no conflicts of interest.
Resources from the same session
484P - Treatment (tx) patterns and outcomes in resectable early-stage EGFR-mutated (EGFRm) NSCLC in South Korea: Subgroup analysis of a global real-world (rw) study
Presenter: Myung-Ju Ahn
Session: Poster Display
Resources:
Abstract
485P - LDCT lung cancer screening of never-smokers meta-analysis subgroup analysis: Adenocarcinoma is the highly predictive histology identified in never-smokers
Presenter: Sai-Hong Ou
Session: Poster Display
Resources:
Abstract
486P - Fiscal feasibility and implications of integrating lung cancer screening into Hong Kong’s healthcare system
Presenter: Herbert Ho Fung Loong
Session: Poster Display
Resources:
Abstract
487P - Evaluating the performance of the USPSTF lung cancer screening guidelines in an Asian population of lung cancer patients
Presenter: Jian Wei Tan
Session: Poster Display
Resources:
Abstract
488P - Pulmonary ground glass opacity lesions: Immune ecosystem and its clinical relevances of early-stage lung adenocarcinoma
Presenter: Shensi Shen
Session: Poster Display
Resources:
Abstract
489TiP - BGB-LC-202 (NCT05577702): Phase II Umbrella study of tislelizumab (TIS) monotherapy and TIS-based immunotherapy combinations +/- chemotherapy (CT) as neoadjuvant treatment in Chinese patients (pts) with resectable stage II to IIIA non-small cell lung cancer (NSCLC)
Presenter: Wentao Yu
Session: Poster Display
Resources:
Abstract
491P - Furmonertinib as adjuvant therapy for elderly patients in resected EGFR-mutated non-small cell lung cancer: A double-center, real-world experience
Presenter: Ziheng Wu
Session: Poster Display
Resources:
Abstract
492P - Penpulimab-based combination neoadjuvant/adjuvant therapy for patients with resectable locally advanced non-small cell lung cancer: Preliminary results from a phase II study (ALTER-L043)
Presenter: Changli Wang
Session: Poster Display
Resources:
Abstract
493P - The prognostic value of 4L lymph node dissection in left-sided operable non-small cell lung cancer: A systematic review and meta-analysis
Presenter: Lei Peng
Session: Poster Display
Resources:
Abstract
495P - Intrinsic STING of CD8+T cells regulates self-metabolic reprogramming and exerts anti-tumor effects
Presenter: Qiuli Xu
Session: Poster Display
Resources:
Abstract