Dr. Drilon on Tepotinib and Gefitinib in MET+ EGFR-Mutant NSCLC

Alexander E. Drilon, MD, medical oncologist, Memorial Sloan Kettering Cancer Center, discusses the combination of tepotinib and gefitinib (Iressa) in patients with MET-positive EGFR-mutant non—small cell lung cancer (NSCLC).

There are 2 types of MET activation in lung cancer, explains Drilon. The cancer can be dependent on MET alone or the cancer can acquire a dependence on MET in the case of an EGFR mutation. A patient who receives a first- or second-generation EGFR TKI can develop MET amplification. A substantial amount of patients who receive osimertinib (Tagrisso), a third-generation inhibitor, also develop MET amplification, notes Drilon.

Therefore, several programs have investigated the combination of an EGFR and MET inhibitor. The combination of tepotinib and gefitinib has shown activity in a select group of patients, says Drilon. As was the case with de-novo MET amplification, the higher the amplification, the higher the response. The median progression-free survival in patients with MET amplification was 21.2 months with the combination versus 4.2 months with chemotherapy.