Niels Reinmuth, MD, PhD, leader of the Thoracic Oncology Department, Asklepios Lung Clinic, member of the German Cancer Society, the German Society of Pulmonology, the International Association for the Study of Lung Cancer, the European Society for Medical Oncology, and the American Society of Clinical Oncology, discusses the rationale for a health utility analysis of tepotinib (Tepmetko) in patients with 

ex14) skipping mutation–positive non–small cell lung cancer (NSCLC).

The utility analysis was based on patient-reported outcomes collected as part of the phase 2 VISION trial (NCT02864992), which examined the agent in those whose tumors harbor 

 alterations. The study sought to address the significant unmet need for treatment options for this population, as this subset is known to be difficult to treat and often has poor prognoses and poor responses to chemotherapy, according to Reinmuth. Moreover, these alterations are most often seen in those with sarcomatoid differentiation, Reinmuth adds.

Although immunotherapy has demonstrated benefit in this patient population, there is always a need for more targeted approaches to treatment, Reinmuth says. Given that tepotinib was designed to target 

 skipping alterations, this provides the rationale to further evaluate the health utility of the agent in this subset and to develop additional targeted therapies to address these alterations, Reinmuth concludes.

Videos

Niels Reinmuth, MD, PhD, discusses the rationale for a health utility analysis of tepotinib in patients with MET exon 14 skipping mutation–positive non–small cell lung cancer.

Dr. Reinmuth on the Rationale for Examining PROs With Tepotinib in METex14-Altered NSCLC 

Niels Reinmuth, MD, PhD, leader of the Thoracic Oncology Department, Asklepios Lung Clinic, discusses ongoing studies looking at resistance to EGFR TKIs in patients with 

-positive non—small cell lung cancer (NSCLC).

There are a number of ongoing trials with osimertinib (Tagrisso) in which researchers are collecting tissue samples and performing liquid biopsies at the time of diagnosis and at the time of disease progression. Reinmuth says the field is eagerly awaiting the results of the studies as they could provide insight into mechanisms of resistance. There are also similar studies looking at other EGFR TKIs like dacomitinib (Vizimpro) that may give researchers a better idea of the biology driving response and acquired resistance.

In addition, ongoing studies are looking to overcome resistance with combination therapies that can be administered either as a frontline regimen or as a second-line treatment after resistance to osimertinib. These combinations include an EGFR TKI with chemotherapy, an antiangiogenic agent, immunotherapy, and other modalities, Reinmuth says.

Niels Reinmuth, MD, PhD, leader of the Thoracic Oncology Department, Asklepios Lung Clinic, discusses ongoing studies looking at resistance to EGFR TKIs in patients with EGFR-positive non–small cell lung cancer.

Dr. Reimuth Discusses Studies Looking at Resistance to EGFR TKIs in NSCLC

Niels Reinmuth, MD, PhD, leader of the Thoracic Oncology Department, of the Asklepios Lung Clinic, discusses the results of the phase III MYSTIC study (NCT02453282), which evaluated the efficacy and safety of first-line durvalumab (Imfinzi) plus tremelimumab versus platinum-based chemotherapy in patients with metastatic non—small cell lung cancer.

Overall survival was analyzed in subgroups based on baseline clinical characteristics. Unfortunately, there was no single clinical characteristic identified. Although durvalumab was effective across all subgroups, it was not found to be statistically significant. This was predetermined, says Reinmuth, because there were 3 primary endpoints.

However, it appears that subsequent immunotherapy might have impaired the overall survival (OS) benefit of durvalumab in the first-line. About two-thirds of patients crossed over to receive a form of immunotherapy, although durvalumab was not permitted as a cross-over option. If statistical methods are applied, it appears that this subsequent immunotherapy may have led to improved outcomes in the chemotherapy-treated group.

Niels Reinmuth, MD, PhD, discusses the results of the MYSTIC study, which evaluated first-line durvalumab plus tremelimumab versus platinum-based chemotherapy in patients with metastatic non–small cell lung cancer.

Niels Reinmuth, MD, PhD

Articles

Dr. Reinmuth on the Rationale for Examining PROs With Tepotinib in METex14-Altered NSCLC

Dr. Reimuth Discusses Studies Looking at Resistance to EGFR TKIs in NSCLC

Dr. Reinmuth on Findings from the MYSTIC Study