Massachusetts General Hospital Cancer Center, Boston, MA
Rebecca Suk Heist , Monica Motwani , Fabrice Barlesi , Jonathan Wade Goldman , Karen Kelly , Yan Sun , Jun Wu , Bruce Allen Bach , D. Ross Camidge
Background: c-Met overexpression (OE) and MET amplification (amp) are prognostic of poor outcome for non-small cell lung cancer (NSCLC). Telisotuzumab vedotin (ABBV-399; teliso-v [T]), an anti–c-Met Ab and monomethyl auristatin E drug conjugate, showed efficacy as monotherapy (mono) and combined with erlotinib (T+Er) in a phase 1/1b trial (NCT02099058) in NSCLC patients (pts) with c-Met OE. Here, c-Met OE (by immunohistochemistry [IHC]) and its association with T efficacy were explored. IHC, mRNA, and amp platforms for MET were also compared. Methods: Archival tissue from pts with NSCLC in the phase 1/1b trial was examined. c-Met was assessed centrally by IHC with SP44 Ab (Ventana Medical Systems) and pts with c-Met OE (membrane H-score [H-S] of ≥150) were enrolled. MET mRNA expression was analyzed from total RNA and sequenced on HiSeq 3000 (Illumina). MET amp was analyzed by FISH (MET/CEP7 ratio of ≥2) or whole-exome sequencing (copy number ≥2). Efficacy in the T mono every 2 (TQ2W) or 3 (TQ3W) weeks and the T+Er EGFR mutant cohorts was assessed for IHC H-S ≥150 and ≥225. Results: As of Dec 2018, 238 pts with NSCLC were screened centrally for c-Met OE. Of these, 118 pts were enrolled. For screened pts, 76%/37% of nonsquamous (NSQ, n = 201) and 58%/16% of squamous (SQ, n = 32) pts had H-S ≥150/≥225; 75%/41% of NSQ and 55%/16% of SQ NSCLC pts had ≥50% cells with 2+/3+ staining intensity. MET amp was reported for 5 pts, all with high H-S (≥270); there was an association between MET amp and MET RNA levels (n = 4) (t-test p value: 0.0002). See Table for ORR and median PFS by H-S and T treatment. Conclusions: c-Met expression prevalence in NSCLC showed a similar trend as in previous reports. In T+Er-treated pts, ORR was higher for those with c-Met H-S ≥225 than ≥150–< 225, suggesting that biomarker expression may act as an effect size multiplier. Optimization of the c-Met IHC cutoff warrants further investigation. Clinical trial information: NCT02099058
H-S | NSQ, TQ2W | NSQ, TQ3W | EGFR mutant, T+Er | ||||||
---|---|---|---|---|---|---|---|---|---|
N | ORR, % | PFS, m (CI) | N | ORR, % | PFS, m (CI) | N | ORR, % | PFS, m (CI) | |
≥150 | 16 | 37.5 | 5.2 (1.7, 8.8) | 17 | 11.8 | 2.7 (1.2, NA) | 28 | 35.7 | 5.3 (2.8, NA) |
≥150–< 225 | 9 | 33.3 | 5.2 (0.7, NA) | 9 | 11 | 1.4 (1.1, NA) | 12 | 16.7 | 3.7 (1.4, NA) |
≥225 | 7 | 42.9 | 8.0 (1.2, 9.1) | 8 | 12.5 | NR (1.2, NA) | 16 | 50 | NR (2.7, NA) |
NA, not available; NR, not reached.
Disclaimer
This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org
Abstract Disclosures
2022 ASCO Annual Meeting
First Author: Jonathan W. Goldman
2023 ASCO Annual Meeting
First Author: Yong Won Choi
2024 ASCO Annual Meeting
First Author: Shen Zhao
2024 ASCO Annual Meeting
First Author: Mariana da Rocha Almeida Brandao