Successful Tepotinib Challenge After Capmatinib-Induced Interstitial Lung Disease in a Patient With Lung Adenocarcinoma Harboring MET Exon 14 Skipping Mutation: Case Report

Transient asymptomatic pulmonary opacities in a patient with MET exon 14 skipping non‐small cell lung cancer: A case report

“… 11 , 12 , 13 There are reports of patients with MET‐TKI‐induced ILD who are able to switch to a different MET‐TKI and restart treatment. 10 , 14 However, the patient in this case was able to continue on the same MET‐TKI, albeit at a reduced dose, without steroid use. Although the possibility of TKI‐induced ILD could not be completely ruled out in this case, we considered TAPOs to be the most likely cause of GGOs.…”

“…There are several reports of readministration of the same EGFR‐TKI in patients with suspected EGFR‐TKI‐induced ILD, all accompanied by steroid use 11–13 . There are reports of patients with MET‐TKI‐induced ILD who are able to switch to a different MET‐TKI and restart treatment 10,14 . However, the patient in this case was able to continue on the same MET‐TKI, albeit at a reduced dose, without steroid use.…”

“…As a limitation, tepotinib‐induced ILD was also suspected owing to the appearance of shadows after initiation of tepotinib in this case. In general, pulmonary toxicity, such as ILD, is not associated with dose intensity, 10 making it difficult to reinitiate the same TKI. There are several reports of readministration of the same EGFR‐TKI in patients with suspected EGFR‐TKI‐induced ILD, all accompanied by steroid use 11–13 .…”

Safety of Tepotinib Challenge after Capmatinib-Induced Pneumonitis in a Patient with Non-Small Cell Lung Cancer Harboring MET Exon 14 Skipping Mutation: A Case Report

“…Whether the dose intensity of MET inhibitors correlates with lung toxicity remains unknown. According to a previous case report, low-dose tepotinib is safe for patients with a history of grade 2 capmatinib-induced pneumonitis [ 7 ]. However, corticosteroids were not used due to mild symptoms and a normal oxygen saturation level in that case.…”

“…Drug-induced pneumonitis, also known as interstitial lung disease (ILD), is an uncommon but life-threatening adverse effect of target therapies [ 5 ]. While the GEOMETRY and VISION trials and ensuing clinical studies reported lung-related adverse effects, the incidence of pneumonitis was low (2–6%) and reported cases were limited [ 6 , 7 , 8 ]. The mechanism of drug-induced pneumonitis is not well known and may result from an MET-dependent or -independent cause, based on the selected epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) [ 5 ].…”