Capmatinib (Tabrecta) in Lung Cancer – Effectiveness in Real-World Data
In this article
Lung cancer is the most common cancer worldwide and the leading cause of cancer-related death. Developing treatment options for patients with advanced non-small cell lung cancer (NSCLC) is vital. One innovative targeted cancer drug in this field, approved for patients whose tumors carry a genetic alteration called MET exon 14 skipping (METex14), is Tabrecta, containing the active ingredient capmatinib . This is an innovative targeted treatment for cancer. Its first FDA approval, on 6 May 2020, is considered a major advance in the MET kinase inhibitor class.
How Capmatinib Works
Capmatinib is a targeted treatment that inhibits MET kinase, stopping cancer cells from growing and multiplying. METex14, a specific mutation in the MET gene, occurs in 3-4% of NSCLC cases. This mutation causes cancer cells to grow and multiply uncontrollably. Capmatinib's ability to specifically treat cells carrying this mutation gives it a distinctive role in this field.
Capmatinib Effectiveness in Real-World Data
On 31 May 2023, Journal of Clinical Oncology published a study evaluating the real-world effectiveness of capmatinib in patients with advanced NSCLC carrying a METex14 mutation.
Conducted after FDA approval and based on real-world data outside clinical trials, this study showed that patients receiving capmatinib achieved better clinical outcomes than those treated with immunotherapy (IT) or chemotherapy (KT).
Patients treated with capmatinib had higher real-world response rates (rwORR) and longer real-world progression-free survival (rwPFS), overall survival (OS), and time on treatment (TTD).
Results
- A total of 287 eligible patients were identified.
- The median age was 63.3 years, and 71% were men.
- At diagnosis, 15 patients had brain metastases.
- Patients receiving capmatinib as first-line (1B) treatment had higher real-world response rates (rwORR) and longer progression-free survival (rwPFS), overall survival (OS), and time on treatment (TTD) than those receiving immunotherapy (IT), chemotherapy (KT), or their combination.
- Patients receiving capmatinib as second-line (2B) treatment achieved higher rwORR than those receiving other treatments, although this was a smaller patient population.
Clinical Outcomes by Treatment Line
1. First-Line Treatments
| Treatment | Capmatinib (146 patients) | IT (48 patients) | IT+KT (63 patients) | KT (30 patients) |
| rwORR, % (95% CI) | 73.4% (65.2-80.5) | 68.8% (53.8-81.3) | 54.8% (41.7-67.5) | 52% (31.3-72.2) |
| rwPFS, median (95% CI), months | Not Estimable (NE) | 12.6 (11.1-NE) | 12.0 (9.0-12.6) | 10.1 (5.9-NE) |
| rwPFS at 18 months, % (95% CI) | 68.0% (51.9-79.7) | 48.1% (21.2-70.8) | 29.9% (15.5-45.8) | 38.4% (17.9-58.7) |
| OS, median (95% CI), months | NE | NE (14.3-NE) | 29.9 (20.2-32.1) | 17.6 (10.9-NE) |
| OS at 18 months, % (95% CI) | 92.6% (84.9-96.5) | 77.4% (43.8-92.3) | 69.3% (52.9-81.0) | 48.3% (23.1-69.7) |
| TTD, median (95% CI), months | 19.1 (12.4-NE) | 12.6 (9.0-NE) | 8.8 (6.6-10.0) | 5.5 (4.1-5.8) |
2. Second-Line Treatments
| Treatment | Capmatinib (26 patients) | IT (13 patients) | IT+KT (10 patients) | KT (15 patients) |
| rwORR, % (95% CI) | 83.3% (58.6-96.4) | 38.5% (13.9-68.4) | 62.5% (24.5-91.5) | 50% (23.0-77.0) |
| rwPFS, median (95% CI), months | NE (4.4-NE) | 9.1 (4.2-NE) | 8.2 (3.8-NE) | 3.4 (3.1-5.8) |
- rwORR (Real-World Response Rate): response rate in real-world practice
- rwPFS (Real-World Progression-Free Survival): progression-free survival in real-world practice
- OS (Overall Survival): overall survival
- TTD (Time to Treatment Discontinuation): the time until treatment is stopped (time on treatment)
- NE: (Not Estimable): cannot be estimated
- 95% CI: (Confidence Interval): 95% confidence interval
- IT: Immunotherapy
- KT: Chemotherapy
- IT+KT: Combination of immunotherapy and chemotherapy
Conclusion
The success of capmatinib in patients with advanced NSCLC carrying a METex14 mutation once again highlights the potential of targeted cancer treatments. The results suggest that capmatinib may be preferred in this patient group, particularly as first-line treatment. Capmatinib therefore holds an important place in advanced NSCLC treatment, aiming to improve patients' quality of life and survival.
Related topic: Capmatinib (Tabrecta) Prescribing Information
Sources
DOI:10.1200/JCO.2023.41.16_suppl.e21112
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