Abstract:
Objective To explore the efficacy and safety of savolitinib in the treatment of patients with advanced non-small cell lung cancer (NSCLC) with the MET 14 exon skipping mutation and to analyze the relationship between drug concentration, efficacy, and adverse reactions.
Methods We retrospectively analyzed 16 clinical records and plasma drug concentrations of patients with locally advanced or metastatic NSCLC admitted to the Peking University Cancer Hospital & Institute, between April 2018 and September 2019. All carried the MET 14 exon skipping mutation and received treatment with savolitinib. We evaluated the efficacy and safety of savolitinib treatment, analyzed the correlation between drug concentration and efficacy, and the correlation between drug concentration and adverse reactions. The progression-free survival (PFS) and overall survival (OS) of patients were followed up, and the median PFS and OS were calculated using the Kaplan-Meier method.
Results Sixteen patients presenting NSCLC with the MET 14 exon skipping mutation received treatment with savolitinib, including nine males (56.3%) aged 51-84 years. The pathological types included 11 cases of lung adenocarcinoma, 5 cases of pulmonary sarcomatoid carcinoma, and 1 case of lung squamous cell carcinoma. The objective response rate to savolitinib was 50.0% (8/16), and the disease control rate was 87.5% (14/16). The plasma valley concentrations of savolitinib in patients who achieved partial remission and those who did not were 77.2 ng/mL and 146.7 ng/mL, respectively (P=0.06). The peak concentrations of savolitinib for patients who experienced grade 2 or above adverse reactions during treatment and those who only experienced grade 1 adverse reactions were 116.5 ng/mL and 93.2 ng/mL, respectively (P=0.59). The median PFS was 8.5 months, and the median OS was 14.1 months.
Conclusions Savolitinib has a good therapeutic effect on NSCLC with MET mutations, and the adverse reactions are tolerable. Under conventional dosage, there may be a negative correlation between the plasma valley concentration and the efficacy of savolitinib; however, there was no significant correlation between drug concentration and adverse effects.