Impact of MET inhibitors on survival among patients with non-small cell lung cancer harboring MET exon 14 mutations: a retrospective analysis.
By: Mark M Awad, Giulia C Leonardi, Sasha Kravets, Suzanne E Dahlberg, Alexander Drilon, Sinead A Noonan, D Ross Camidge, Sai-Hong I Ou, Daniel B Costa, Shirish M Gadgeel, Conor E Steuer, Patrick M Forde, Viola W Zhu, Yoko Fukuda, Jeffrey W Clark, Pasi A Jänne, Tony Mok, Lynette M Sholl, Rebecca S Heist

Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, USA. Electronic address: mark_awad@dfci.harvard.edu.
2019-03-12; doi: 10.1016/j.lungcan.2019.05.011
Abstract

Objectives

Although dramatic responses to MET inhibitors have been reported in patients with MET exon 14 (METex14) mutant non-small cell lung cancer (NSCLC), the impact of these treatments on overall survival in this population is unknown.

Methods

We conducted a multicenter retrospective analysis of patients with METex14 NSCLC to determine if treatment with MET inhibitors impacts median overall survival (mOS). Event-time distributions were estimated using the Kaplan-Meier method and compared with the log-rank test. Multivariable Cox models were fitted to estimate hazard ratios.

Results

We identified 148 patients with METex14 NSCLC; the median age was 72; 57% were women and 39% were never smokers. Of the 34 metastatic patients who never received a MET inhibitor, the mOS was 8.1 months; those in this group with concurrent MET amplification had a trend toward worse survival compared to cancers without MET amplification (5.2 months vs 10.5 months, P =  0.06). Of the 27 metastatic patients who received at least one MET inhibitor the mOS was 24.6 months. A model adjusting for receipt of a MET inhibitor as first- or second-line therapy as a time-dependent covariate demonstrated that treatment with a MET inhibitor was associated with a significant prolongation in survival (HR 0.11, 95% CI 0.01-0.92, P =  0.04) compared to patients who did not receive any MET inhibitor. Among 22 patients treated with crizotinib, the median progression-free survival was 7.4 months.

Discussion

For patients with METex14 NSCLC, treatment with a MET inhibitor is associated with an improvement in overall survival.



Copyright © 2019 Elsevier B.V. All rights reserved.

PMID:31200835






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