Treatment patterns and clinical outcomes in Chinese patients with NSCLC with MET alterations resistant to EGFR‑TKI therapy

The present study evaluated therapeutic strategies and clinical outcomes in Chinese patients with mesenchymal-epithelial transition (<i>MET</i>) alterations in non-small cell lung cancer (NSCLC) who were progressing on epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI), aiming to address the unmet need of overcoming <i>MET</i>-driven resistance. A real-world study was conducted, involving eligible patients with NSCLC treated at Jiangnan University Affiliated Hospital between February 2022 and April 2024. Based on the treatment regimen, patients were categorized into three groups: MET-TKI combined with EGFR-TKI, chemotherapy-based regimen, and other regimens. The primary outcomes were the objective response rate (ORR), time to treatment failure (TTF), post-progression survival (PPS) and adverse events (AEs). A total of 32 patients were included in the analysis. The MET-TKI plus EGFR-TKI group (n=10) achieved the highest ORR at 55.6%, followed by the chemotherapy-based regimen group (n=15) at 42.9% and the other regimens group (n=7) at 14.3%. The median TTF was 9.5 months for the MET-TKI plus EGFR-TKI group, compared with 4.4 and 3.6 months for the chemotherapy-based and other regimens groups, respectively (P=0.748). Similarly, the median PPS was 14.4 months in the MET-TKI plus EGFR-TKI group, compared with 9.4 and 7.0 months in the chemotherapy-based and other regimens groups, respectively (P=0.733). Treatment-related AEs varied among the groups, with nausea, peripheral edema and rash being the most common in the MET-TKI plus EGFR-TKI group. In conclusion, the combination of MET-TKI and EGFR-TKI demonstrates promising benefits in terms of TTF, PPS and ORR, underscoring its potential as a viable treatment option. The modest improvements observed, coupled with the inherent limitations of the present study, emphasize the necessity for further research to optimize treatment strategies and gain a deeper understanding of the long-term efficacy of combination therapy in addressing <i>MET</i>-driven resistance to EGFR-TKI.