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  • 1
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 80, No. 16_Supplement ( 2020-08-15), p. 3385-3385
    Abstract: Purpose: In the ongoing, single-arm, Phase 2 VISION study (NCT02864992), tepotinib (a highly selective MET inhibitor) has shown durable clinical activity in NSCLC patients (pts) with METex14 skipping. Here, we report the biomarker profile of pts screened with liquid biopsy (LBx) for inclusion in the study. Methods: Pts with advanced NSCLC and previously confirmed EGFR/ALK wild-type status were prospectively screened for MET alterations using plasma samples collected during pre-screening/screening. Plasma ctDNA sequencing was performed at a central laboratory using a 73-gene next-generation sequencing panel (Guardant360®). Results: Of 6,034 pts screened, 813 pts had results pending at data cut and of 5,221 pts tested, sequencing failed in 41 pts. The success rate of LBx testing was consistent across centers. Of 5,180 patients analyzed, 694 pts (13.4%) had no mutation detected. Despite the intent of screening EGFR/ALK wild-type pts, 327 pts (6.3%) had EGFR mutations and 49 (0.9%) had ALK/ROS fusions. 188 pts (3.6%) had METex14 skipping (Table) and 256 pts (4.9%) had MET amplification (amp) without METex14 skipping. The median age of METex14 pts was 72 years; 47% were male; 46% were never smokers and 65% had adenocarcinoma histology. In METex14 pts, the most frequently occurring driver co-alterations were amp in MET (13.3%), EGFR (7.4%), CDK4 (6.4%), BRAF (5.3%) and CDK6 (4.8%), and mutations in GNAS (5.3%). In METamp pts, the most frequently occurring driver co-alterations were CDK6 (60.5%), BRAF (43.4%), EGFR (28.9%), MYC (21.9%) and CCNE1 (19.9%) amps. Overall, TP53 mutations were detected in 55.9% of METex14 pts and 79.7% of METamp pts. Table:Characterization of METex14 skipping (n=188)n (%)Insertions/deletions (indels)93 (49.5)Indel at acceptor site54 (28.7)Indel at donor site36 (19.1)Whole exon 14 deletion3 (1.6)Single nucleotide variation (SNV)95 (50.5)SNV at donor site93 (49.5)SNV at acceptor site2 (1.1)SNVs and indelsSNV/indel at donor site129 (68.6)SNV/indel at acceptor site56 (29.8)SNV/indel whole exon 14 deletion3 (1.6) Conclusions: In this population, METex14 skipping can be successfully detected through non-invasive LBx analysis using a next-generation sequencing panel. The rate of METex14 skipping and the genomic profile and demographics of pts were similar to previously reported data. Citation Format: Xiuning Le, Dariusz Kowalski, Byoung Chul Cho, Pierfranco Conte, Enriqueta Felip, Marina Chiara Garassino, Santiago Viteri, Gee-Chen Chang, John Richart, Luiz Paz-Ares, Dilafruz Juraeva, Josef Straub, Christopher Stroh, Paul Paik. Liquid biopsy to detect MET exon 14 skipping (METex14) and MET amplification in patients with advanced NSCLC: Biomarker analysis from VISION study [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 3385.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
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    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2020
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  • 2
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 38, No. 15_suppl ( 2020-05-20), p. 9556-9556
    Abstract: 9556 Background: Preliminary tepotinib data showed durable activity in pts with NSCLC with METex14 skipping prospectively identified by liquid (L+) or tissue (T+) biopsy. Having met target enrollment of ≥60 L+ pts & ≥60 T+ pts, we report primary data. Methods: VISION Cohort A enrolled pts with advanced EGFR/ALK wt, METex14 skipping NSCLC (asymptomatic brain metastases [BM] allowed), who received oral tepotinib 500 mg QD. On-study treatment decisions were based on investigator assessment (INV) of response. Primary endpoint was objective response rate (ORR) by independent review committee (IRC) analyzed in 3 primary ITT sets: L+ and/or T+, L+, T+. 2ary endpoints included ORR by INV, duration of response (DOR), disease control rate (DCR), PFS, OS, & safety. Preplanned analyses were performed in pts with BM at baseline (BL). BL/on-treatment ctDNA plasma samples (L+) were analyzed using a 73-gene NGS panel (Guardant360). Deep molecular responses (MR), defined as 〉 75% depletion of METex14, were compared with objective responses (OR). Results: By data cut-off (1 Oct 19) 151 pts received tepotinib (safety set); 99 L+/T+, 66 L+, 60 T+ pts comprised the 3 ITT sets with ≥6-month [m] follow-up. Across treatment lines (n = 44 1L, n = 55 ≥2L), primary ORR & mPFS [95% CI] in 99 L+/T+ pts were 43% [34–54] & 8.6 m [6.9–11.0] by IRC and 56% [45–66] & 9.5 m [6.7–13.5] by INV. ORR was similar in L+ or T+ pts (table) or in T+L− pts (n = 25): 40% [21–61] by IRC and 48% [28–69] by INV. Only 2 pts were T−L+. Outcomes were also comparable in pts with BM (n = 11): IRC ORR 55% [23–83] & mPFS 10.9 m [8.0–ne]. 34/51 pts (67%) with matched BL/on-treatment L+ samples had deep MR strongly associated with clinical response: 32/34 pts (94%) with MR had disease control (INV), including 29/34 pts (85%) with OR; 2/34 pts had progressive disease. Further biomarker data will be presented. Grade ≥3 treatment-related adverse events (TRAEs) were reported by 37/151 pts (25%). 13 pts (9%) discontinued due to TRAEs. Conclusions: Tepotinib is a promising targeted therapy with durable clinical activity and manageable toxicity in pts with METex14 skipping NSCLC L+ or T+, including pts with BM. High ORR & DCR in pts with ctDNA molecular responses support that MET inhibition in METex14+ tumor cells can lead to clinical benefit. Clinical trial information: NCT02864992 . [Table: see text]
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
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    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2020
    detail.hit.zdb_id: 2005181-5
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  • 3
    In: New England Journal of Medicine, Massachusetts Medical Society, Vol. 383, No. 10 ( 2020-09-03), p. 931-943
    Type of Medium: Online Resource
    ISSN: 0028-4793 , 1533-4406
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    Language: English
    Publisher: Massachusetts Medical Society
    Publication Date: 2020
    detail.hit.zdb_id: 1468837-2
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