Amivantamab plus capmatinib in advanced non-small cell lung cancer (NSCLC) harboring MET alterations: Recommended phase 2 combination dose and preliminary dose-escalation results from the phase 1/2 METalmark study.

Authors

null

Alexander I. Spira

Virginia Health Specialists, Fairfax, VA

Alexander I. Spira , Byoung Chul Cho , Tae Min Kim , Sang-We Kim , Bing Xia , Eunice Artis , Jessica Dobbs , Christine Baudelet , Mahadi Baig , Mehmet Ali Nahit Sendur

Organizations

Virginia Health Specialists, Fairfax, VA, Cancer Center, Yonsei University College of Medicine, Seoul, South Korea, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea, Janssen Research & Development, San Diego, CA, Janssen Research & Development, Bridgewater, NJ, Janssen Research & Development, Beerse, Belgium, Janssen Research & Development, Raritan, NJ, Department of Medical Oncology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey

Research Funding

Janssen Global Services LLC

Background: Amivantamab (ami) is an EGFR-MET bispecific antibody with immune cell-directing activity. Ami monotherapy has demonstrated meaningful clinical activity in MET-driven advanced NSCLC, including in patients (pts) harboring MET exon 14 skipping mutations (METex14) (1) and MET amplification (amp) (2) Capmatinib (cap) is an intracellular-targeting MET TKI approved for METex14-mutated advanced NSCLC (3). Simultaneously targeting MET’s extracellular and intracellular regions could achieve more potent inhibition than either agent alone. Here, we report preliminary results and the identification of the recommended phase 2 combination dose (RP2CD). Methods: The open-label METalmark study (NCT05488314) includes a combination dose selection phase in pts with advanced NSCLC, followed by an expansion phase in pts with treatment-naïve METex14, refractory METex14, or MET amp (3 cohorts), lacking EGFR or ALK mutations. For phase 1 dose-selection, pts must have had disease progression on or intolerance to prior therapy. Dose levels assessed were DL0 at 700 mg (1050 mg if ≥80 kg) ami IV + 400 mg oral cap twice daily (BID) and DL+1 at 1050 mg (1400 mg if ≥80 kg) ami IV + 400 mg cap oral BID. Primary endpoints were dose-limiting toxicity (DLT) during Cycle 1, Days 1-28 and safety. Results: As of 8 Nov 2023, 18 pts were dosed, with a median follow-up of 3.3 months. There were 10 pts at DL0 (9 DLT evaluable) and 8 pts at DL+1 (all DLT evaluable). In the first DL0 cohort, 1 pt (of 4 DLT evaluable) reported a DLT, grade 3 nausea, prior to the adoption of nausea/vomiting recommendations. Among the remaining 5 DLT-evaluable pts at DL0, there were no DLTs, meeting prespecified criteria for escalation to DL+1. No DLTs were observed among the 8 pts at DL+1. Among all pts, the median number of prior lines was 3 (range, 1–5) and the following driver mutations were detected: EGFR Ex19del (6 pts) and L858R (6 pts), METex14 (4 pts), MET amp (2 pts), EGFR Exon 20 insertion (1 pt), and KRAS G12V (1 pt). There was 1 partial response (PR; MET amp+Ex19del), 2 unconfirmed PRs (1 METex14, 1 L858R; both ongoing), and 8 stable diseases observed as a best overall response. Preliminary PK data suggest similar exposure for the combination vs individual agents. Among the 8 treatment discontinuations, 6 were due to progressive disease, 1 withdrew consent, and 1 due to respiratory failure (unrelated to study treatments). Most common AEs were primarily EGFR- and MET-related. Rate of peripheral edema was 28% (5/18), none grade ≥3. Updated results will be reported at the meeting. Conclusions: RP2CD for ami+cap was identified as a combination of each approved dose. Initial safety profile of ami+cap does not appear to have additive MET-related toxicities. 1. Leighl JTO 2023;18(11):S93-94, OA21.04. 2. Haura JCO 2019;37:15_suppl, 9009. 3, Wolf NEJM 2020;383(10):944-957. Clinical trial information: NCT05488314.

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Abstract Details

Meeting

2024 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Lung Cancer—Non-Small Cell Metastatic

Track

Lung Cancer

Sub Track

Metastatic Non–Small Cell Lung Cancer

Clinical Trial Registration Number

NCT05488314

Citation

J Clin Oncol 42, 2024 (suppl 16; abstr 8619)

DOI

10.1200/JCO.2024.42.16_suppl.8619

Abstract #

8619

Poster Bd #

483

Abstract Disclosures