Efficacy and tolerability of capmatinib in a very elderly patient with metastatic NSCLC harboring a MET exon 14 mutation

Abstract

We report the case of an 87-year-old female patient who was diagnosed with metastatic non-small-cell lung cancer harboring MET exon 14 skipping mutation (MET ex14) and PD-L1 expression of 60%. A first-line treatment with atezolizumab was started with primary resistance. Then, a second-line treatment with capmatinib, a selective type Ib MET tyrosine kinase inhibitor, was started, achieving a partial response. The patient is still alive and on treatment with capmatinib 300 mg twice daily after 20 months, with a good tolerability and no evidence of disease progression.

In summary, our patient experienced a long-lasting response (>18 months) with capmatinib as second-line treatment. Further analyses evaluating the efficacy and tolerability of MET tyrosine kinase inhibitors are warranted, especially in the elderly, a non-small-cell lung cancer population whose tumors could more frequently harbor MET ex14 mutation.

Executive summary

• Lung cancer is the leading cause of cancer related death.

• Tyrosine kinase inhibitors targeting specific genetic alterations in non-small-cell lung cancer (NSCLC) significantly improved response rate and survival outcomes.

• MET exon 14 skipping mutations, found in 3–4% of NSCLC, are more frequent in elderly patients.

• Capmatinib and tepotinib demonstrated efficacy for MET ex14 skipping mutations.

• Our case report showed capmatinib effectiveness in elderly NSCLC patient, maintaining a good quality of life.

Keywords: :

• capmatinib
• elderly
• MET exon 14 skipping mutation
• MET tyrosine kinase inhibitors
• NSCLC

Financial disclosure

The authors have no financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Competing interests disclosure

F Gelsomino received honoraria or personal fees for advisory roles or consulting from Eli Lilly, Novartis, AstraZeneca and Bristol-Myers Squibb outside the submitted work. The authors have no other competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript apart from those disclosed.

Writing disclosure

No writing assistance was utilized in the production of this manuscript.

Informed consent disclosure

For our work entitled “Efficacy and tolerability of capmatinib in a very elderly, pretreated patient with metastatic NSCLC harboring a MET exon 14 skipping mutation: a case report”, informed oral consent has been obtained from the patient involved.

An oral consent was obtain because the patient is currently off-site.

The patient accepted treatment with capmatinib as part of an EAP program. We received a favorable opinion from our ethics committee (CE di Area Vasta Emilia Centro) with the approval number of 114/2022/Compass/AOUBo.