Tepotinib in patients with non-small cell lung cancer with high-level METamplification detected by liquid biopsy: VISION Cohort B

High-level METamplification (METamp) is a primary driver in ∼1%–2% of non-small cell lung cancers (NSCLCs). Cohort B of the phase 2 VISION trial evaluates tepotinib, an oral MET inhibitor, in patients with advanced NSCLC with high-level METamp who were enrolled by liquid biopsy. While the study was halted before the enrollment of the planned 60 patients, the results of 24 enrolled patients are presented here. The objective response rate (ORR) is 41.7% (95% confidence interval [CI], 22.1–63.4), and the median duration of response is 14.3 months (95% CI, 2.8–not estimable). In exploratory biomarker analyses, focal METamp, RB1wild-type, MYCdiploidy, low circulating tumor DNA (ctDNA) burden at baseline, and early molecular response are associated with better outcomes. Adverse events include edema (composite term; any grade: 58.3%; grade 3: 12.5%) and constipation (any grade: 41.7%; grade 3: 4.2%). Tepotinib provides antitumor activity in high-level METamp NSCLC (ClinicalTrials.gov: NCT02864992).