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1. MET
Exon 14 jump mutation advanced NSCLC in real-world clinical practice and progression-free survival [1]
Treatment patterns and progression-free survival in MET exon 14 (METex14) skipping advanced non-small cell lung cancer (aNSCLC) in real-world clinical practice.
Cheryl Ho, et al.
Poster 1180p, Presented at the 2022 European Society for Medical Oncology (ESMO) congress
Background: MET exon 14 (METex14) jump mutation is an oncogenic driver mutation that is present in 3-4% of patients with advanced non-small cell lung cancer (NSCLC). Teppotinib and camatinib have been approved in many countries since the first regulatory approval of MET-specific TKI in 2020. In the Phase II VISION study, tepotinib showed positive and durable clinical efficacy in advanced NSCLC patients carrying METex14 jump mutations (N = 313; data deadline: February 20, 2022), with an objective response rate (ORR) of 50.8% (95% CI: 45.1, 56.5), median duration of remission (mDOR) of 18.0 months (95% CI: 12.4, ne), and median progression-free survival (mPFS) of 11.2 months (95% CI: 9.5, 13.8). Due to the lack of randomized studies in advanced NSCLCs carrying METex14 jump mutations, comparative data that can replace such studies need to be explored to evaluate the effectiveness of MET-TKI compared with commonly used treatments such as chemotherapy and immunotherapy. We summarized data from 5 real-world sources of advanced NSCLC patients carrying METex14 jump mutations before receiving treatment before MET-TKI approval, reporting their treatment patterns and PFS.
Method: Patient-level data comes from 5 real-world data sources. The patient records were imported into a general data model, which adopted consistent definitions of baseline characteristics such as smoking history and histology , and adopted selection/exclusion criteria consistent with VISION study. First-line treatment is defined as the first treatment received after diagnosis of advanced or metastatic disease, and the number of subsequent treatment lines is calculated accordingly. Among the various line treatments, treatment types are classified as: immunotherapy, chemotherapy, targeted therapy (excluding MET inhibitors), or MET inhibitor therapy. In datasets where progression events were not collected, time to next treatment or death (TTNTD) was used as an alternative indicator of PFS; when TTNTD is also unavailable, it was used in treatment time.
Results: Patient characteristics: 248 patients were included in the analysis and received a total of 516 treatments. Among them, 229 treatments were first-line treatment, and 287 treatments were second-line treatments or above. Overall, the median age was 72 years old, with 53% of patients being female and 54% having a history of smoking.
treatment sequence: regardless of the number of treatment lines, most of the 516 treatments received can be classified as chemotherapy (204), MET inhibitor treatment (137; more than 90% are gramzotinib ) or immunotherapy (119; mainly pembrolizumab and nivolumab). Overall, the first-line treatment received by patients was mainly chemotherapy (the treatment line of 118/220 can be determined; 9 trials were experimental treatment).
PFS of various treatment types: mPFS was 5.0 months (95% CI: 4.5, 7.5) in patients receiving chemotherapy, 3.9 months (95% CI: 3.4, 5.2); mPFS was 3.6 months (95% CI: 2.0, 10.2) in patients receiving immunotherapy, 3.3 months (95% CI: 2.5, 5.7); mPFS was 8.0 months (95% CI: 4.0, 11.1) in patients receiving MET inhibitors, and 7.0 months (95% CI: 5.6, 9.9).
Conclusion: International real-world analysis conducted by before MET-specific TKI was approved showed that patients with advanced NSCLC with METex14 jump mutations had limited benefits from receiving chemotherapy, immunotherapy and crizotinib treatment. These data support the optimal treatment of patients with advanced NSCLC using approved MET-specific TKI as the best treatment for METex14 jump mutations.
comment expert
Liu Xiaoqing professor
Chief physician and doctoral supervisor
Department of Oncology Medicine, Fifth Medical Center, General Hospital of the People's Liberation Army
Deputy Chairman of the Expert Committee of Small Cell Lung Cancer
Standing Committee of the Lung Cancer Professional Committee of China Anti-Cancer Association
Deputy Chairman of the Professional Committee of Precision Medicine and Oncology Rehabilitation
Deputy Chairman of the Chinese Medical Care International Exchange Promotion Association oncology Medicine Branch
Health Expert of the Central Military Commission
Expert comment
MET 14 Exon jump mutation is an independent oncogenic driver gene, with an incidence rate of about 3%-4% [2] in NSCLC. Several studies have shown that MET ex14 jump mutation is an independent prognostic factor, predicting a shorter survival time than wild type [3-4]. The detection of MET ex14 jump mutations should be an important part of the precise treatment of lung cancer. The NCCN guidelines, ESMO guidelines and CSCO guidelines recommend extensive molecular map detection to identify lung cancer driver mutations, including EGFR, ALK, BRAF, MET ex14, etc. This poster presented at this year's ESMO conference summarizes five real-world data sources for patients with advanced NSCLC who have jump mutations in MET ex14 before specific MET-TKI are approved. From the results, we can see that before the specific MET-TKI was approved, the treatment methods received by these patients were mainly chemotherapy, but mPFS was only 5 months, and the mPFS was 3.6 months in patients receiving immunotherapy for the first-line. Even if the targeted therapeutic drug crizotinib is used in the first-line, it can only reach 8 months of PFS, which is difficult to satisfy the efficacy of patients with advanced METex14 mutant. According to the results of GEOMETRY mono-1 research, patients receiving camatinib treated with mPFS can reach 12.5 months and OS can reach 25.5 months [5]. These data support MET-specific TKI is the best treatment option for patients with advanced NSCLC with METex14 jump mutation.
targeted drugs for MET ex14 jump mutations have developed rapidly, such as camatinib, terpotinib, sevotinib, etc., which have been approved for relevant indications abroad or at home. Regarding camatinib, its prospective, global multicenter registered clinical study, GEOMETRY mono-1 updated its data at the 2022 European Lung Cancer Conference (ELCC) for the first-line treatment cohort, with the Blind Independent Review Committee (BIRC) assessing first-line treatment ORR of 68.3% (95% CI: 55.0, 79.7), mPFS: 12.5 months (95% CI: 8.3, 18.0), and mOS: 25.5 months (95% CI: 15.2, NE) [5]. Camatinib also has excellent efficacy in patients with brain metastasis. In the GEOMETRY mono-1 study, 7 of the 13 evaluable brain lesions had intracranial responses at the first evaluation, and all brain lesions in 4 patients completely resolved. Finally, a total of 12 patients were controlled (92.3%) [6]. RECAP, a large sample size real-world study of 81 patients published in WCLC in 2022, once again verified the efficacy and safety of camatinib in the real world. The results showed that the ORR of camatinib for the first-line application can reach 68%, mPFS was 10.6 months, and the adverse reactions related to grade 3 and above treatment are mainly peripheral edema (13%), increased creatinine (4%) and increased liver enzymes (3%). The overall safety and controllability of [7]. For tepotinib, data updated by the VISION study at 2022 ESMO showed that the ORR of patients with MET ex14 jump mutation NSCLC who were confirmed by tissue or liquid biopsy was 56.1% (95% CI: 48.1, 63.8), mPFS was 12.6 months (95% CI: 9.6, 17.7), and mOS was 19.1 months (95% CI: 13.7, 23.7) [8]. The results of the Phase II study conducted by celvotinib in China show that the mPFS of the initial and medically treated populations were 6.9 months, the mOS of the initial and medically treated populations was 10.9 months, and the mOS of the initial and medically treated populations was 19.4 months, and the mOS of the traditionally treated population was 19.4 months [9]. Based on the excellent efficacy of camatinib and stable clinical mutual verification data, the FDA will accelerate approval to routine approval in August 2022. Camatinib becomes the only METex14 jump inhibitor routinely approved by the FDA. The NCCN guidelines give priority to the first line of the NCCN guidelines to treat MET ex14 jumping NSCLC patients [10]. We look forward to camatinib being approved in China as soon as possible to benefit more Chinese patients.
2. MET 14 advanced non-small cell lung cancer primary treatment patients based on PD-L1 status [11]
Real-world treatment patterns and outcomes based on PD-L1 status in treatment-naive patients with METex14 advanced non-small cell lung cancer
Natasha Leighl, et al
Poster 1112p, Presented at the 2022 European Society for Medical Oncology (ESMO) congress
Background: selective MET inhibitor (METi) camatinib and terpotinib were accelerated approval from the FDA in 2020 and 2021 based on the results of GEOMETRY mono-1 and VISION Phase II clinical trials, respectively. On August 10, 2022, camatinib was routinely approved by the FDA, becoming the first MET inhibitor routinely approved for the treatment of metastatic METex14 jump NSCLC patients. has limited evidence of efficacy of chemotherapy and immunotherapy in patients with METex14 NSCLC compared to targeted therapy. This real-world study aims to understand the baseline characteristics, treatment patterns, and clinical outcomes of patients with advanced METex14 NSCLC in the United States based on PD-L1 status stratified during the FDA accelerated approval period.
Method: This retrospective and observational cohort study was included in the deidentified patient information of the Flatiron Health Foundation Medicine clinical genome database (FH-FMI-CGDB) in the United States, and correlated and matched the patient clinical data provided by about 280 cancer clinics in the United States. Patients with advanced METex14 NSCLC who started first-line treatment between October 2016 and November 2021 were included. The data deadline is March 31, 2022, and the follow-up time is ≥ 4 months. Baseline characteristics and treatment patterns of patients with tumor proportional score (TPS) ≥ 50% (high PD-L1), TPS 1%-49% (low PD-L1), TPS 1% (PD-L1 negative), and PD-L1 undetected/unknown (PD-L1 unknown) were described according to the PD-L1 status. The Kaplan-Meier method analyzed the first-line progression-free survival (PFS) and overall survival (OS) (uncorrected), and real-world PFS and OS in patients with high PD-L1 group.
Results: included 138 patients with advanced METex14 jump NSCLC, most of which were high PD-L1 TPS expression (41.3%) or unknown PD-L1 (38.4%). The tumor mutation burden in 75.4% of the patients was low (TMB 10 mut/Mb), and only 11.6% of the patients (n=16) had high TMB (≥ 10 mut/Mb), and another 13% of the patients (n=8) had unknown TMB. Among patients with known TMB, the median (Q1-Q3) TMB was 50 (2.5-6.7) mut/Mb. The most common first-line regimen was immunoselective therapy in the
PD-L1 hyperexpression group (n = 20, 35.1%), while the PD-L1 hypoexpression group (n = 12, 63.2%) were immunocompromised chemotherapy, and the PD-L1 negative (n = 5, 55.6%) and unknown (n = 18, 34.0%) were chemotherapy. Regardless of the PD-L1 group, 24 patients (20.8%) received selective MET inhibitors in the first line (indexed May 2020). Of the 26 patients retrieved in 2021, 11 patients (42.3%) received selective MET inhibitors in the first line. In the high and low PD-L1 groups, only 45.6% and 42.1% of patients received second-line treatment, with the frequency of selective MET inhibitors (14%, 21.1%) higher than other treatment options (Pictures A-B), while about 56% and 51% of patients received second-line treatment in the PD-L1-negative group and PD-L1 unknown group, respectively (Pictures C-D).
All patients (n=138) had a median PFS of 5.6 (95% CI 4.6-70) months and a median OS of 18.7 (95% CI 11.4-26.2) months. The median PFS of the high PD-L1 group with anti-PD-1/anti-PD-L1 treatment (n=29) and other first-line regimens (n=28) were 4.1 (95% CI 1.4-62) months vs 5.4 (95% CI 3.8-10.0) months, and the median OS was 11.4 (95% CI 3.1-not at [NR]) months vs 17.0 (95% CI 7.0-NR) months, respectively. Because only 11 patients in the high PD-L1 group received first-line treatment with selective MET inhibitors (Picture A), the investigators did not analyze PFS and OS in these patients.
Conclusion: This real-world study stratified patients with advanced METex14 jump sequence NSCLC according to PD-L1 expression levels, providing insights into their treatment patterns and clinical outcomes.Patients with high or low expression of PD-L1 mainly receive immunotherapy (including anti-PD-1/anti-PD-L1 monoclonal antibody treatment), while median PFS and median OS are numerically lower than other first-line regimens. The proportion of selective MET inhibitors in the first-line treatment of METex14 jump NSCLC patients is relatively limited, highlighting the need for targeted treatment in this type of patients and further verifying the research results in larger sample studies, as well as evaluating the effectiveness of selective MET inhibitors in the real world.
Comments Expert
Zhang Hongmei Professor
Doctoral supervisor
Director of the Oncology Department of Xijing Hospital
Mainly engaged in the internal medicine treatment of lung cancer and other malignant tumors
Chinese Anti-Cancer Association Multiple primary and primary unknown metastatic cancer Deputy Chairman
Chinese Clinical Oncology Association Immunotherapy Committee Standing Committee
Shaanxi Anti-Cancer Association Tumor Comprehensive Treatment Committee
Expert comments
MET14 Exon jump mutation (MET) Δ14) is a oncogenic driver. The proportion of mutations in patients with non-small cell lung cancer (NSCLC) is about 3%-4% [2]. It is commonly found in elderly patients (median age 72 years old) and has a history of smoking. It is generally not combined with other oncogenic mutations and is a predictor of poor prognosis of NSCLC. At present, domestic and foreign guidelines unanimously recommend MET Δ14 as a routine molecular detection, and multiple MET inhibitors have also been approved for the treatment of metastatic MET Δ14 NSCLC adult patients, such as carmatinib, terpotinib, sevotinib, etc.
In recent years, research data on advanced NSCLC based on PD-1/PD-L1 has been emerging. This study uses MET Δ14 patients as the research subject. Based on the expression of PD-L1, the treatment patterns and clinical outcomes of such patients were retrospectively analyzed from October 2016 to March 2022. The study found that the proportion of patients who detect PD-L1 expression has increased significantly from 25% from 2016 to 2017 to 80.8% in 2021. In 138 patients with MET Δ14 included, 41.3% of patients with high PD-L1 TPS expression accounted for 41.3%, and the most commonly selected first-line treatment plan was immunosuppressive monotherapy; the first-line treatment plan was immunocompromised combined chemotherapy in patients with low PD-L1 expression, and chemotherapy in patients with negative PD-L1 and unknown. Regardless of the expression of PD-L1, in 2020, the proportion of patients receiving MET inhibitors in the first line was 20.8%, and rose to 42.3% in 2021, indicating that with the popularization of PD-L1 detection, targeted and new immunotherapy drugs, the treatment pattern of NSCLC is changed. It is worth noting that with the coexistence of multiple treatment options, more and more clinicians are beginning to be confused: How to choose the best first-line solution for patients with high PD-L1 expression and MET Δ14?
This paper provides some tips for the above problems. The study shows that the median PFS of patients with high expression of PD-L1 (n=29) who received immunotherapy in the first line was 4.1 months and the median OS was 11.4 months; in the GEOMETRY mono-1 study, patients with MET Δ14 (cohort 5b and cohort 7, n=57) received camatinib treatment, with a median PFS of 12.5 months and a median OS of 25.5 months [5]; if non-head-to-head comparison is performed, the PFS and OS of targeted therapy have significant advantages in numerical value. The disadvantage is that the number of patients included in this study is small (n=11), and no PFS and OS data on the treatment of MET inhibitors for patients with high PD-L1 expression were reported. Research on a larger sample size is to further explore the best first-line treatment options for patients with NSCLC with high PD-L1 expression and MET Δ14.
However, interpreting real-world research is more controversial and challenging than RCTh. First, the data in this article are extracted from electronic health records and may be missing or incomplete, especially when patients receive treatment in non-specified tumor clinics; second, the study data are mainly from the United States community and cannot represent the treatment situation in other regions; third, MET Δ14 patients are relatively rare, with only 29 patients with high PD-L1 expression, limiting further interpretation of the results; finally, patients selected within 60 days of the day, before or after the reporting date of the gene database in this article cannot exclude selection bias.
In short, clinical research is very necessary to solve clinical needs. Research on NSCLC patients with high PD-L1 expression and MET Δ14 is still in progress. We look forward to a larger sample size and higher evidence level in the future as a reference to help and implement the precise and individualized treatment concept of advanced NSCLC patients to meet the treatment needs of patients.
3. Pembrolizumab and placebo as adjuvant therapy for completely resected stage IB-IIIA non-small-cell lung cancer (PEARLS/KEYNOTE-091): an interim analysis of a randomized, three-blind, phase 3 trial [12]
Pembrolizumab versus placebo as adjuvant therapy for completely resected stage IB-IIIA non-small-cell lung cancer (PEARLS/KEYNOTE-091): an interim analysis of a randomised, triple-blind, phase 3 trial.
O'Brien M, et al
The Lancet. Oncology
IF = 35.386
Background: Pembrolizumab is a standard treatment drug for advanced non-small cell lung cancer. The study evaluated Pembrolizumab as an adjuvant treatment for completely resected stage IB-IIIA NSCLC.
Method: In this randomized, three-blind, phase 3 trial (PEARLS/KEYNOTE-091), patients were recruited from 196 medical centers in 29 countries. Patients with complete resection, pathology, confirmed stage IB (tumor diameter ≥ 4 cm), stage II or stage IIIA NSCLC with a compliant age of ≥ 18 years, with an Eastern Tumor Cooperative Group's physical fitness status score of 0 or 1 according to any histological or PD-L1 expression level of the American Joint Cancer Commission Stage System (7th Edition); adjuvant chemotherapy is considered in stage IB diseases, and adjuvant chemotherapy is strongly recommended in stage II and IIIA diseases according to national and local guidelines. Using a central interactive speech response system, using minimization techniques and stratified by disease staging, previous adjuvant chemotherapy, PD-L1 expression and geographical area, subjects were randomly assigned (1:1) to the Pembrolizumab 200 mg group or placebo group, administered intravenously every 3 weeks for up to 18 cycles. Subjects, researchers, and analysts remain blind to treatment allocation. The primary endpoint was disease-free survival in the total population and PD-L1 tumor proportional score (TPS) ≥ 50%. Validity was assessed in the intention-to-treat (ITT) population (i.e., all subjects randomly assigned to the treatment group). Safety was assessed among all the patients who were randomly assigned to receive at least one dose of treatment. Here, this study reports the results of the second interim analysis, pre-provided when approximately 118 disease-free survival events occurred in PD-L1 TPS ≥ 50% of the population.
Results: Between January 20, 2016 and May 6, 2020, 1177 of the 1955 screened subjects were randomly assigned to the Pembrolizumab group (n = 590, including n = 168 with PD-L1 TPS ≥ 50% n = 168) or placebo group (n = 587; n = 165 with PD-L1 TPS ≥ 50% n = 165) and included in the ITT population. As of the data deadline for this interim analysis (September 20, 2021), the median follow-up time was 35.6 months (IQR 27.1 - 45.5). In the overall population, the median disease-free survival was 53.6 months (95% CI 39.2 to not reached) in the Pembrolizumab group and 42.0 months (95% CI 31.3 to not reached) in the placebo group (HR 0.76 [95% CI 0.63 to 0.91], p = 0.0014). Among the PD-L1 TPS ≥ 50%, neither the Pembrolizumab group (95% CI 44.3, not achieved) or the placebo group (95% CI 35.8, not achieved; HR 0.82 [95% CI 0.57 - 1·18]; p = 0.14) did not achieve median disease-free survival. Grade 3 adverse events occurred in 198 of 580 subjects treated with Pembrolizumab and 150 of 581 subjects treated with placebo. At least 10 subjects in each treatment group had safety events of ≥3, with hypertension (35 [6%]) and pneumonia (12 [2%]) in the Pembrolizumab group and hypertension in the placebo group (32 [6%]). Severe adverse events occurred in 142 (24%) subjects in the Pembrolizumab group and 90 (15%) subjects in the placebo group; more than 1% of the participants in the Pembrolizumab group were pneumonia (13 [2%]), pneumonia (12 [2%]) and diarrhea (7 [1%]) and pneumonia (9 [2%]) in the placebo group. Treatment-related adverse events that resulted in death occurred in 4 (1%) subjects treated with Pembrolizumab (1 died of cardiogenic shock and myocarditis, 1 died of septic shock and myocarditis, 1 died of pneumonia, and 1 died of sudden death of ), and no cases occurred in subjects treated with placebo.
Conclusion: Pembrolizumab significantly improved disease-free survival compared to placebo and was independent of the new safety signal in completely resection, unselected PD-L1 phase IB-IIIA NSCLC.Regardless of PD-L1 expression, Pembrolizumab may become a new treatment option when phase IB-IIIA NSCLC after complete resection requires adjuvant chemotherapy.
4. MPS1 inhibits immunogenicity of KRAS-LKB1 mutant lung cancer sex [13]
MPS1 inhibition primes immunogenicity of KRAS-LKB1 mutant lung cancer.
Kitajima S, et al.
Cancer cell
IF =23.916
Due to endogenous mitochondrial dysfunction, KRAS-LKB1 (KL) mutant lung cancer silences the expression of interferon gene stimulating factor (STING), impairing T cell infiltration and developing resistance to PD-(L)1 treatment. Here, it was found that KL cells also minimize the accumulation of 2’3’-loop GMP-AMP (2’3’-cGAMP) in cells, further inhibiting downstream STING and STAT1 activation. An unbiased screen found this vulnerability, transient MPS1 inhibition (MPS1i) that can effectively reactivate pathways in KL cells through micronucleus generation. This effect is significantly amplified by STING's epigenetic deinhibition and requires only pulsed MPS1i treatment, creating a therapeutic window compared to non-dividing cells. After single-course decitabine treatment, MPS1i impact therapy can restore T cell infiltration in the body, enhance the anti-PD-1 efficacy, and produce long-lasting remission without obvious evidence of toxicity.
5. AENEAS: Randomized Phase III Trial of Ametinib Versus Gefitinib as First-Line Therapy for Locally Advanced or Metastatic Non-Small-Cell Lung Cancer With EGFR Exon 19 Deletion or L858R Mutation Mutations.Lu S, et al.
Journal of clinical oncology: official journal of the American Society of Clinical Oncology
IF = 28.245
Purpose: ametinib is a novel third-representative dermal growth factor receptor tyrosine kinase inhibitor approved in China. This double-blind Phase III clinical trial evaluated the effectiveness and safety of ametinib versus gefitinib first-line treatment for locally advanced or metastatic EGFR mutant non-small cell lung cancer (NSCLC).
Method: Patients from 53 research centers in China were randomly treated with ametinib (110 mg) or gefitinib (250 mg) in a 1:1 ratio, once daily. The primary endpoint was the progression-free survival (PFS) assessed by the investigator.
Results: 429 patients with locally advanced or metastatic NSCLC were enrolled in , and the PFS in the ametinib group was significantly longer than that in the gefitinib group (hazard ratio, 0.46; 95% CI, 0.36-0.60; P 0001). The median PFS was 19.3 months (95% CI, 17.8 to 20.8) in the ametinib group and 9.9 months (95% CI, 8.3 to 12.6) in the gefitinib group. The objective response rates and disease control rates in the ametinib group and the gefitinib group were similar (the objective response rates were 73.8% and 72.1% respectively; the disease control rates were 93.0% and 96.7%, respectively). The median remission duration for ametinib was 18.1 months (95% CI, 15.2 to N/A) and gefitinib was 8.3 months (95% CI, 6.9 to 11.1). Adverse events of grade 3 severity (of any cause) were observed in 36.4% and 35.8% of patients in the ametinib group and gefitinib group, respectively. The incidence of rash and diarrhea (any grade) in the ametinib-treated group was 23.4% and 16.4%, respectively, and 41.4% and 35.8% in the gefitinib-treated group, respectively.
Conclusion: ametinib is a well-tolerated third-representation dermatological growth factor receptor tyrosine kinase inhibitor, which can be used as a first-line treatment option for EGFR mutant NSCLC.
References:
[1]. Cheryl Ho, et al. 2022 ESMO 1180P
[2].Socinski MA, Pennell NA, Davies KD.JCO Precis Oncol. 2021;5:PO.20.00516.
[3].Tong JH, Yeung SF, Chan AW, et al.Clin Cancer Res. 2016;22(12):3048-3056.
[4].Yeung SF, Tong JHM, Law PPW, et al. al.J Thorac Oncol. 2015;10(9):1292-1300.
[5].Jurgen W, et al. 2022 ELCC 26P
[6].Garon EB, et al. Oral presentation at the AACR 2020 (virtual meeting); abstract CT082.
[7].Oliver ILLNI, et al. 2022 WCLC EP08.02-122
[8].Smith Egbert F et al. 2022 ESMO 985P
[9].Lu S, Fang J, Li X, et al. Lancet Respir Med. 2021;9(10):1154-1164.[10].Non-small cell lung cancer. NCCN Guidelines Version 5. 2022
[11].Natasha Leighl et al.2022 ESMO, 1112P
[12].Mary O'Brien, et al. Lancet Oncol. 2022 Oct;23(10):1274-1286.
[13].Shunsuke Kitajima, et al. Cancer Cell. 2022 Oct 10;40(10):1128-1144.e8.
[14].Shun Lu, et al.J Clin Oncol. 2022 Sep 20;40(27):3162-3171.Note: The indications of carbatinib and terpotinib NSCLC have not been approved in mainland China. The purpose of this information is to provide relevant knowledge in the field of disease, improve the level of disease cognition, and non-advertising purposes. The information involved in this material is for reference only. Please follow the opinions or guidance of doctors or other medical and health professionals.
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