The clinical value and real efficacy of Capmatinib in the treatment of lung cancer, and price comparison at home and abroad

1. Patients’ real dilemma: Why do people start paying attention to capmatinib?

Today, with the rapid development of targeted tumor therapy, lung cancer patients often face the following problems:

"My genetic test results show that I have MET 14 exon skipping mutation. What kind of medicine can I take?"

"New drugs are on the market, but can they be purchased? Will medical insurance reimburse them?"

“Original drugs abroad are too expensive, are generic drugs reliable?”

These confusions reflect the most realistic contradiction in the field of precision cancer treatment: the efficacy of new drugs is often exciting, but the price and accessibility make many patients "sigh in anticipation of the drugs." In this context, Capmatinib (Capmatinib, brand name Tabrecta) has become the focus of discussion between patients and doctors.

It is the world's first targeted drug approved for the treatment of METex14 mutated non-small cell lung cancer (NSCLC), and represents a major breakthrough in the field of MET inhibitors. With the launch of capmatinib in China and its entry into the medical insurance catalog, domestic patients finally have a new treatment option.

2. What is capmatinib? What is the mechanism of action?

Capmatinib, developed by Novartis (Novartis), is a highly selective MET tyrosine kinase inhibitor. Its target is METgene14 exon skipping mutation (METex14 skipping), which is a special type of NSCLC patients, with an incidence rate of about 3%-4%.

Abnormalities in the MET pathway often lead to abnormal proliferation, metastasis and resistance to apoptosis of tumor cells. Traditional chemotherapy or immunotherapy is not effective for these patients, and capmatinib effectively blocks the growth and spread of cancer cells by inhibiting the MET signaling pathway.

In2020, capmatinib was designated and approved as a breakthrough therapy by the USFDA, becoming the world's first targeted drug targeting the METex14 mutation. Its launch not only fills the treatment gap, but also becomes an important symbol of the progress of precision medicine.

3. Efficacy data: What are the results of clinical trials?

The efficacy of capmatinib mainly comes from the GEOMETRY mono-1 study. This is an open-label, multi-cohort phase II study specifically evaluating the efficacy of capmatinib in METex14mutatedNSCLC.

1. Untreated patients (initial treatment group)

Objective response rate (ORR): 68%

Median progression-free survival (PFS): 12.4months

Some patients experience lasting remission, even lasting more than2 years.

2. Patients who have been previously treated (re-treatment population)

ORR：41%

MedianPFS:5.4months

Significant improvement compared to traditional chemotherapy.

3. Patients with intracranial metastasis

Capmatinib has some central nervous system activity, and tumor shrinkage has also been observed in patients with brain metastases.

4. Security

Common adverse reactions include peripheral edema, nausea, fatigue, abnormal liver function, etc. Most of them are grade 1-2 and can be controlled by adjusting the dosage or symptomatic treatment.

Judging from the data, capmatinib has a particularly significant effect on patients who were initially treated, and it also provides new treatment possibilities for patients who are re-treated.

4. Analysis of prices and medical insurance at home and abroad

Drug prices and medical insurance coverage are important factors affecting patient choice.

1. Domestic market situation

Capmatinib has been successfully approved for marketing in China in2023 and entered the medical insurance catalog.

This means that eligible patients can obtain medication with the support of medical insurance reimbursement based on prescriptions, significantly reducing their financial burden.

However, due to the short time on the market, the supply in some hospitals and pharmacies has not yet been fully rolled out, so patients may encounter certain difficulties when purchasing.

2. Overseas market price

In the United States, the price of the original drug Capmatinib is very high, and the cost of treatment for one year often reaches hundreds of thousands of dollars, equivalent to hundreds of thousands of RMB.

In Europe and Japan, the price is slightly lower, but overall it is still at the level of tens of thousands of yuan per box.

3. Generic drug selection

With the promotion of capmatinib, some countries have developed generic drugs.

In the market represented by Laos, the price of generic drugs is only 2000multiple yuan/ box. The ingredients are basically the same as the original drugs, and the price advantage is significant.

This is a realistic solution for patients who cannot afford originator drugs in the long term.

5. How patients choose: original drugs, generic drugs and medical insurance

For patients, how to find the best path for them among different options?

1. Advantages of original research drugs

The quality is stable, and the data on efficacy and safety are more complete.

Purchase through regular channels and have complete medical guidance and pharmaceutical support.

However, the price is high, and even if it is covered by medical insurance, some patients still have a heavy burden.

2. Advantages of generic drugs

The ingredients are basically the same, the price is low, and the economic burden is significantly reduced.

For patients with limited financial conditions, it can improve compliance and the sustainability of long-term medication.

However, you need to pay attention to the source of medicines and avoid fake or inferior medicines.

3. The significance of medical insurance policy

Capmatinib's entry into the medical insurance catalog represents the country's support for innovative drugs and care for patients.

As the medical insurance reimbursement policy is gradually implemented, the actual out-of-pocket amount of patients will decrease significantly.

6. Medication precautions and practical challenges

1. Genetic testing is a prerequisite

Capmatinib is only suitable for patients with positive mutations in METex14. Therefore, molecular testing must be performed first to avoid blind use of the drug.

2. Adverse reaction management

Common side effects such as peripheral edema require attention to diet and monitoring; abnormal liver function requires regular examination.

3. The Importance of Doctor’s Guidance

Targeted drugs are not "health products". Patients need full guidance from oncologists during the medication process to avoid voluntary discontinuation or dressing changes that may affect the efficacy.

4. Drug accessibility issues

Because it has just been launched in China, pharmacies and hospitals in some areas have insufficient inventory, which makes it still difficult for patients to actually purchase it.

7. Future Prospects: Market and Research Directions of Capmatinib

Medical insurance implementation effect: With the implementation of medical insurance policies, the patient population is expected to expand rapidly.

Real-world data: Real medication data from Chinese patients in the future will further verify its efficacy and safety.

Exploration of combination therapy: Combination with immunotherapy or other targeted drugs will become a research hotspot.

Popularization of generic drugs: The popularity of generic drugs will continue to drive down drug prices and further reduce the burden on patients.

The advent of capmatinib has filled the treatment gap for patients with METex14 mutationsNSCLC. Its efficacy has been widely verified by clinical studies, especially in the treatment-naïve population. However, price and accessibility are still the practical issues that patients are most concerned about. With the coverage of medical insurance and the emergence of generic drugs, more and more patients will have access to such precision treatment drugs.

xa0

References

1.Novartis. Tabrecta® (capmatinib) prescribing information. https://www.novartis.com

2.Wolf J, et al. Capmatinib in MET Exon 14–Mutated or MET-Amplified Non–Small-Cell Lung Cancer (GEOMETRY mono-1). J Clin Oncol.

3.ClinicalTrials.gov. Study of Capmatinib in Adult Participants With MET Exon 14-Altered NSCLC. 4.https://clinicaltrials.gov/ct2/show/NCT02414139

5.Announcement from the Drug Evaluation Center of the State Food and Drug Administration. http://www.cde.org.cn