Tepmetko shifts MET-mutated lung cancer treatment paradigm

Establishes itself as a targeted therapy option for rare mutations … evidence accumulates on its survival benefit

Need for NGS highlighted… limited access to testing remain a challenge

The treatment landscape for non-small cell lung cancer (NSCLC) MET exon 14 skipping alterations is undergoing significant changes within one year of Tepmetko’s reimbursement introduction. In a rare mutation area where targeted treatment options were previously limited, both clinical efficacy and patient access have improved with the introduction of Tepmetko, prompting a redefinition of treatment strategies and highlighting the growing importance of biomarker-based precision medicine.

On the 7th, Merck Korea held a press conference at the Fairmont Hotel in Yeouido, Seoul, to commemorate the first anniversary of the reimbursement of Tepmetko (tepotinib), a treatment for non-small cell lung cancer (NSCLC), and shared clinical outcomes and changes in the actual clinical setting.

A view of the press conference marking the first anniversary of Tepmeco’s reimbursement coverage in Korea

Tepmetko was approved in Korea in 2021 as a treatment for locally advanced or metastatic NSCLC with MET exon 14 skipping alterations and has been reimbursed since April last year. It works by selectively inhibiting MET phosphorylation and downstream signaling, thereby blocking tumor cell proliferation and migration.

MET exon 14 skipping is a representative mutation that causes dysregulation of MET signaling and is known to promote tumor growth and metastasis. Although it is a rare mutation found in approximately 3–4% of metastatic NSCLC patients, it is associated with a poor prognosis and aggressive disease.

Clinical evidence has also accumulated. In the global Phase II VISION study, Tepmetko demonstrated tumor reduction in over 90% of patients, with an objective response rate (ORR) of 58.6%, progression-free survival (PFS) of 15.9 months, and overall survival (OS) of 29.7 months. The duration of response was 46.4 months, confirming long-term treatment benefits.

Subgroup analysis in Asian patients showed similar results, with an ORR of 56.6%, PFS of 13.8 months, and OS of 25.5 months, indicating consistent therapeutic benefits in patient populations including Koreans.

Professor Ji-Youn Han of the Department of Hematology and Oncology at the National Cancer Center said, “Before Tepmetko’s introduction, there were no reimbursed treatment options targeting MET mutations, limiting patient access. Significant changes have emerged in the treatment landscape for rare lung cancers in the year since Tepmetko’s reimbursement.”

Need grows for NGS-based testing

Professor Ji-Youn Han of the Department of Hematology and Oncology at the National Cancer Center

\As targeted therapies for NSCLC continue to emerge, the need for next-generation sequencing (NGS) is also increasing.

In NSCLC, multiple biomarkers exist, including MET, EGFR, ROS1, ALK, BRAF, KRAS, and RET. NGS offers the advantage of being able to test for these biomarkers all at once.

While Professor Han positively noted that personalized treatment has become possible even for rare lung cancers such as those with MET mutations, she also pointed out the limitation of how access to NGS-based testing is limited for patients in practice.

She explained, “In Korea, factors such as turnaround time (TAT), cost burden, and difficulty in obtaining adequate samples limit the broader adoption of NGS. While the current 50% patient co-insurance rate is acceptable, further efforts are needed to reduce cost burden and improve testing access to ensure accurate testing for more patients.” 

She added, “Tepmetko has demonstrated consistent response rates and durable treatment effects regardless of biopsy method (tissue or liquid biopsy) or line of therapy. NGS-based biomarker testing offers the advantage of proactively identifying patients who stand to benefit from treatment and providing concrete evidence for establishing treatment strategies and selecting medications.”