Abstract 1182P
Background
We evaluated the characteristics of adult patients (pts) with METex14 skipping aNSCLC using RW data predating the FDA approval of the two MET tyrosine kinase inhibitors (TKIs), tepotinib and capmatinib.
Methods
This retrospective cohort study used the electronic health record-derived de-identified Flatiron Health database to identify US pts with METex14 skipping aNSCLC who initiated first-line (1L) treatment from Jan 1, 2011 to Sep 30, 2019 with ≥3 months’ follow-up. The index date was the start of 1L therapy. Descriptive analyses assessed the distribution of sample demographics and clinical characteristics. Pt characteristics were categorized by line of therapy, with second line (2L) as a subset of 1L, and the presence of brain metastases (BM) at index.
Results
Of 108 pts with METex14 skipping aNSCLC who initiated 1L treatment, median age at index was 75 (range 46–85) yrs, 54.6% were female, and 52.8% (n=57) had 2L treatment (table). 63.0% pts had a history of smoking and most were Stage IIIB–IV at initial diagnosis (73.1%); 7.4% had squamous cell carcinoma. 75.9% had an index date of 2016–2019. Of 89/108 pts with genomic testing prior to 1L, no pts were reported to have KRAS, ROS-1 or BRAF mutations. Of 31 pts with available PD-L1 expression data, 13 (41.9%) had high PD-L1. Tumor mutation burden (TMB), assessed in 61 pts, was low (mean [SD], 6.6 [4.7]). Of 23 pts with BM at index (21.3%), median age was 72 (48–85) yrs, 56.5% were female, 73.9% had a history of smoking, and 91.3% had Stage IIIB–IV at initial diagnosis. Table: 1182P
| Characteristics | 1L (N=108) | 2L (n=57) | BM (n=23) |
| Age, years | |||
| Median (range) | 75 (46–85) | 73 (46–85) | 72 (48–85) |
| Sex, n (%) | |||
| Female | 59 (54.6) | 34 (59.6) | 13 (56.5) |
| Race, n (%) | |||
| White | 77 (71.3) | 39 (68.4) | 14 (60.9) |
| BMI | |||
| Mean (SD) | 26.8 (5.2) | 26.5 (5.2) | 28.6 (6.4) |
| Smoking history, n (%) | |||
| Yes | 68 (63.0) | 34 (59.6) | 17 (73.9) |
| NSCLC diagnosis to treatment, days | |||
| Mean (SD) | 241.7 (576.6) | 366.1 (359.2) | 207.7 (698.4) |
| Histology, n (%) | |||
| Non-squamous | 94 (87.0) | 47 (82.5) | 22 (95.7) |
| Squamous | 8 (7.4) | 8 (14.0) | 0 |
| Sites of metastases, n (%) | |||
| Bone | 44 (40.7) | 27 (47.4) | 12 (52.2) |
| Brain | 23 (21.3) | 12 (21.1) | 23 (100) |
| Liver | 15 (13.9) | 7 (12.3) | 5 (21.7) |
| ECOG PS, n (%) | |||
| 0 | 21 (19.4) | 9 (15.8) | 3 (13.0) |
| 1 | 37 (34.3) | 20 (35.1) | 8 (34.8) |
| 2 | 13 (12.0) | 11 (19.3) | 3 (13.0) |
Conclusions
Real-world pt demographics and clinical characteristics of the Flatiron cohort confirm pts with METex14 skipping as a distinct population of aNSCLC; older, with/without smoking history, with squamous/non-squamous histology, exclusive of KRAS, ROS-1 or BRAF mutations, and with high PD-L1 but low TMB. Analyses indicate a need for routine testing practices to identify pts prior to systemic therapy, since targeted MET TKI therapies are now available for use.
Clinical trial identification
Editorial acknowledgement
Editorial assistance (funded by Merck Healthcare KGaA, Darmstadt, Germany) was provided by Syneos Health, London, UK.
Legal entity responsible for the study
Merck Healthcare KGaA, Darmstadt, Germany.
Funding
Merck Healthcare KGaA, Darmstadt, Germany (CrossRef Funder ID: 10.13039/100009945).
Disclosure
R.J. Kelly: Financial Interests, Personal, Advisory Role: BMS; Merck Healthcare KGaA, Darmstadt, Germany; Eli Lilly; AstraZeneca; Daiichi Sankyo; EMD Serono, an affiliate of Merck KGaA; Novartis; Takeda; Eisai; Astellas; Ipsen; Novocure; Financial Interests, Institutional, Research Grant: BMS; Eli Lilly. X. Le: Financial Interests, Personal, Advisory Role: AstraZeneca; Eli Lilly; EMD Serono, an affiliate of Merck KGaA; Novartis; Daiichi Sankyo; Hengrui Therapeutics; Financial Interests, Personal, Research Grant: Eli Lilly; Boehringer Ingelheim. K. Luttropp, S. Huse, M.L. Ganz: Financial Interests, Personal, Full or part-time Employment: Evidera Ltd. M. Yang, F. Liu: Financial Interests, Personal, Full or part-time Employment: EMD Serono, Inc., Rockland, MA, USA, an affiliate of Merck KGaA. B. Pfeiffer: Financial Interests, Personal, Full or part-time Employment: Merck Healthcare KGaA, Darmstadt, Germany. P.K. Paik: Financial Interests, Personal, Advisory Role: AstraZeneca; Calithera; Lilly; Takeda; EMD Serono, an affiliate of Merck KGaA; Bicara; Boehringer Ingelheim; Xencor; CrownBio; Financial Interests, Institutional, Research Grant: EMD Serono, an affiliate Merck KGaA; Boehringer Ingelheim; Bicara.