
FDA Approves Companion Diagnostic for Tepotinib in MET Exon 14 mNSCLC
Key Takeaways
- FoundationOne Liquid CDx is now FDA-approved to identify mNSCLC patients with MET exon 14 skipping alterations for tepotinib treatment.
- Tepotinib's regular FDA approval in 2024 followed its 2021 accelerated approval, based on the VISION trial's findings.
The FDA approved the FoundationOne Liquid CDx to identify patients with metastatic non–small cell lung cancer (mNSCLC) with MET exon 14 skipping alterations who may be eligible for tepotinib (Tepmetko; EMD Serono).
This article was first published by
The FDA has approved the FoundationOne Liquid CDx for use as a companion diagnostic to identify patients with metastatic
On February 15, 2024,
“Access to a high-quality liquid biopsy, like FoundationOne Liquid CDx, can help unlock the power of precision medicine for more patients with NSCLC,” said Mia Levy, MD, PhD, chief medical officer at Foundation Medicine,
Both the accelerated and regular approvals of tepotinib were supported by findings from the phase 2 VISION trial (NCT02864992).2 In total, 313 patients with mNSCLC harboring MET exon 14 skipping alterations received tepotinib at the recommended dose of 450 mg once daily until unacceptable toxicity or disease progression. The primary efficacy end points were overall response rate (ORR) and duration of response (DOR). Of 164 previously untreated patients, the ORR was 57% (95% CI, 49%-65%), and 40% of responders had a DOR of at least 12 months. Of 149 previously treated patients, the ORR was 45% (95% CI, 37%-53%), and 36% of responders had a DOR of at least 12 months.
EQ-5D-5L Visual Analogue Scale and EORTC Core Quality of Life (QOL) Global Health Status questionnaire responses demonstrated stability in overall health-related QOL outcomes over time. EORTC QLQ-LC13 symptom scores for dyspnea and chest pain remained stable, and these scores for cough had a clinically meaningful improvement.
A pooled safety population included 448 patients with solid tumors enrolled across 5 open-label, single-arm trials in which they received tepotinib monotherapy at the recommended dose.4 This population included 255 patients from the VISION trial. In the VISION safety population, 45% of patients had serious adverse effects (AEs), the most common being pleural effusion (7%), pneumonia (5%), dyspnea (3.9%), edema (3.9%), general health deterioration (3.5%), musculoskeletal pain (2%), and pulmonary embolism (2%). One patient each died due to pneumonitis, hepatic failure, and dyspnea from fluid overload. The most common AEs included edema, nausea, fatigue, musculoskeletal pain, diarrhea, dyspnea, decreased appetite, and rash.
Further long-term efficacy findings showed that the median progression-free survival (PFS) in the treatment-naive cohort was 12.6 (95% CI, 9.7-17.7) months; the 12- and 24-month PFS rates were 52% (95% CI, 43.0%-60.0%) and 38% (95% CI, 29.0%-47.0%), respectively.5 The median PFS in the previously treated cohort was 15.9 (95% CI, 11.0-49.7)months; the respective 12- and 24-month PFS rates were 59% (95% CI, 48.0%-69.0%) and 42% (95% CI, 30.0%-53.0%).
In the treatment-naïve and previously treated populations, the median overall survivals were 21.3 (95% CI, 14.2-25.9) months and 29.7 (18.8-not evaluable) months, respectively.
“Targeted therapies have led a revolution to how lung cancer is treated,”
References
1. U.S. Food and Drug Administration approves FoundationOneLiquid CDx as a companion diagnostic for Tepmetko (tepotinib) to identify patients with MET exon 14 skipping alterations in non-small cell lung cancer. News release. Foundation Medicine. November 18, 2024. Accessed November 18, 2024.
2. FDA approves tepotinib for metastatic non-small cell lung cancer. News release. FDA. February 15, 2024. Accessed November 18, 2024.
3. FDA grants accelerated approval to tepotinib for metastatic non-small cell lung cancer. News release. FDA. February 3, 2021. Accessed November 18, 2024.
4. Tepmetko. Prescribing information. EMD Serono; 2023. Accessed November 18, 2024.
5. Paik PK, Garassino MC, Le X, et al. Long-term outcomes of tepotinib in patients with MET exon 14 skipping NSCLC from the VISION study. J Clin Oncol. 2023;41(suppl 16):9060. doi:10.1200/JCO.2023.41.16_suppl.9060
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