Expert Guidance Based on Clinical Experience of Tepotinib Side Effect Management in Patients with NSCLC Harboring MET Exon 14 Skipping

December 2021 Vol 12, No 12
Terri Alexander, MSc
MD Anderson Cancer Center, Houston, TX

Background: Tepotinib is a highly selective MET tyrosine kinase inhibitor (TKI), with proven efficacy and tolerability in patients with MET exon 14 (METex14) skipping non–small-cell lung cancer (NSCLC). METex14 skipping occurs in 3% to 4% of patients with NSCLC, and patients are typically elderly; tepotinib offers a new therapeutic option for these patients. The clinical benefits of cancer treatments, including MET TKIs, comes with the risk of adverse events (AEs), which can disrupt treatment duration or intensity, and compromise clinical outcomes. As part of the multidisciplinary teams that coordinate the management of patients with cancer, nurses are integral to the timely identification of AEs, initiation of preventive strategies, and appropriate management.

Objective: To provide guidance for the early identification and effective management of AEs specifically associated with tepotinib treatment in patients with METex14 skipping NSCLC, with the aim of optimizing patient treatment experience and outcomes.

Methods: Visual, nurse-specific guidance was developed following analysis of the clinical features of common AEs associated with tepotinib treatment that highlighted the most frequent AEs and their likely occurrence during the treatment journey. Based on real-world nursing experience, proactive and reactive management approaches are presented to mitigate the impact of these AEs on patients and increase the potential for optimal dosing and treatment duration.

Results: While most tepotinib-associated AEs are manageable, clinically relevant guidance is provided to support appropriate, timely interventions in cases where lack of recognition or symptom visibility could affect clinical outcomes. For example, low-grade edema (a MET inhibitor class effect) is common, even in fit patients, but progression to established edema can make it more difficult to treat. Combining insight into likely AE chronology with early-stage symptoms observed in routine practice (such as unexplained weight gain and skin erosions) and suitable management approaches can support early recognition and effective intervention. Guidance for other common AEs will also be presented.

Conclusion: Supporting timely and effective management strategies to mitigate the impact of common AEs during tepotinib treatment could improve quality of life for elderly patients and contribute to increased time on treatment and the potential for improved outcomes. These are the first nurse-specific recommendations for the management of AEs with tepotinib that will support therapeutic goals by improving the patient experience.

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Last modified: August 10, 2023

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