Dr. Wolf on GEOMETRY mono-1 Phase II Trial With Capmatinib in NSCLC

Jüergen Wolf, MD, medical director, Center for Integrated Oncology, professor, Interdisciplinary Translational Oncology at University Hospital of Cologne, discusses the primary efficacy data of the phase II GEOMETRY mono-1 trial exploring the MET inhibitor capmatinib as treatment for patients with non-small cell lung cancer (NSCLC) and exon-14 mutations.

Patients with an exon-14 mutations account for about 4% of all patients with NSCLC. In the GEOMETRY mono-1 trial, investigators are evaluating the use of capmatinib in patients with different MET alterations, such as MET exon-14 skipping and MET amplifications.

At the 2019 ASCO Annual Meeting, Wolf presented the primary efficacy data with the agent in patients with exon-14—mutated disease. In the trial, two cohorts—treatment-naïve patients and pretreated patients—were tested separately.

Capmatinib yielded promising overall response rates (ORR) over the standard treatment of platinum-based chemotherapy in the treatment-naïve cohort. Specifically, the ORR was 70% with capmatinib versus 20% with chemotherapy. The duration of response observed with the MET inhibitor was about 11 months. Furthermore, the cohort of pretreated patients had an ORR of 40%, with a duration of response of 10 months, says Wolf.

The toxicity seen with capmatinib was significantly lower than what was seen with traditional chemotherapy. The most common adverse events associated with the agent were peripheral edema and gastrointestinal toxicities; however, these events are typically manageable in the clinical setting, says Wolf. Based on what has been seen with this trial, capmatinib as may be a favorable treatment option over standard chemotherapy in this patient population.