New hope for capmatinib in the treatment of non-small cell lung cancer

Capmatinib (Capmatinib) is an oral, small molecule inhibitor of the mesenchymal epithelial transition (MET) factor tyrosine kinase receptor for use in selected patients with non-small cell lung cancer (NSCLC).

Capmatinib received accelerated approval for the same indication on May 6, 2020, based on initial overall response rate and duration of response in the GEOMETRY mono-1 trial (NCT02414139), a multicenter, nonrandomized, open-label, multipurpose trial. Cohort study. Conversion to routine approval was based on data from an additional 63 patients and an additional 22 months of follow-up to assess durability of response and verify clinical benefit.

Efficacy was demonstrated in 160 patients with metastatic NSCLC with mutations leading to MET exon 14 skipping. Patients received capmatinib 400 mg orally twice daily until disease progression or unacceptable toxicity.

The primary efficacy endpoints were ORR and duration of response (DOR) as determined by a Blinded Independent Review Committee (BIRC). Among 60 treatment-naïve patients, the ORR was 68% (95% CI: 55, 80) and the DOR was 16.6 months (95% CI: 8.4, 22.1). Among 100 previously treated patients, the ORR was 44% (95% CI: 34, 54) and the DOR was 9.7 months (95% CI: 5.6, 13).

The median age of patients was 71 years (range, 48 to 90 years). Selected demographics were as follows: 61% female, 77% white, 61% never smokers, 83% had adenocarcinoma, and 16% had central nervous system metastases. Among previously treated patients, 81% had received one prior systemic therapy, 16% had received two prior therapies, and 3% had received three prior systemic therapies. Among previously treated patients, 86% had received prior platinum-based chemotherapy.

The most common adverse reactions (≥20%) in patients were edema, nausea, musculoskeletal pain, fatigue, vomiting, dyspnea, cough, and decreased appetite.

The recommended dose of capmatinib is 400 mg orally twice daily with or without food.

Capmatinib is not currently available on the domestic market, and patients cannot purchase it directly from domestic hospital pharmacies for the time being. According to information, the original version of capmatinib is on the market in Europe. Each box contains 120 tablets of 200mg and the price is about 57,000 yuan. In Hong Kong, China, its specification is 60 tablets of 200mg and the price is about 35,000 yuan. In addition, there are also various versions of capmatinib for sale in the Lao market, with 56 pills per box and the price is roughly between 3,000-4,000 yuan.