Dr. Drilon on Emerging Biomarkers in NSCLC

Alexander Drilon, MD, medical oncologist, clinical director, Early Drug Development Service, Memorial Sloan Kettering Cancer Center, discusses emerging biomarkers in non—small cell lung cancer (NSCLC).

Aside from EGFR, ALK, and ROS1 mutations, there are several emerging biomarkers in NSCLC. The first group are the MET exon 14 alterations, which are found in approximately 4% of patients with NSCLC, says Drilon; these mutations result in activation of the MET pathway, and can be paired with certain targeted therapies. Several MET inhibitors were in development when exon 14 alterations were identified in clinical samples, he adds. Now, clinicians have data on crizotinib (Xalkori), capmatinib, and tepotinib. Capmatinib and tepotinib are selective inhibitors, whereas crizotinib is a multikinase inhibitor. Overall, the inhibitors show response rates around 30%.

In May 2018, crizotinib received a breakthrough therapy designation from the FDA for the treatment of patients with metastatic NSCLC with MET exon 14 alterations following progression on platinum-based chemotherapy. Moreover, a recent report showed that capmatinib induced a response rate above 70% in TKI-naïve patients.