MET exon 14 and MET-amplified non-small-cell lung cancer: the decisions you may face
3 treatment settings, 3 with more than one named option. Each section lays out the options the standard of care names, what each is for, the trials behind them with their recorded results, the side effects and cautions on record, and questions to ask. Built from the cancer page's standard-of-care rows; nothing here is advice for your case.
Advanced MET exon 14, first line or later
Capmatinib (GEOMETRY mono-1) or tepotinib (VISION); platinum-pemetrexed with or without pembrolizumab if the inhibitor is not tolerated or after it.
Capmatinib is a targeted pill for the small group of lung cancers driven by a MET exon 14 skipping mutation, found by tumour sequencing.
Tepotinib is a once-daily targeted pill for lung cancers driven by a MET exon 14 skipping mutation, and the MET inhibitor NICE funds in England.
Capmatinib and tepotinib are two pills for the roughly 3% of lung cancers with a MET exon 14 skipping mutation.
Pemetrexed is the chemotherapy that, with a platinum drug, became the first approved treatment for mesothelioma in 2004, and is still the backbone today.
Carboplatin is a platinum chemotherapy that crosslinks DNA; it is part of the standard pre-surgery regimen for triple-negative breast cancer.
- Tests CapmatinibAdvanced non-small-cell lung cancer with MET exon 14 skipping or MET amplification: capmatinib monotherapy in cohorts by prior treatment and MET gene copy number
Response rate 68% (treatment-naive, n=28) and 41% (previously treated, n=69) in MET exon 14 skipping disease; about a third in high-level MET amplification.
Objective response rate, MET exon 14 skipping (%): Treatment-naive 68 (n=28) vs Previously treated 41 (n=69) · source - Tepotinib Phase II in NSCLC Harboring MET Alterations (VISION)Phase 2NCT02864992337 peopleevidence 33Tests TepotinibA Phase II Single-arm Trial to Investigate Tepotinib in Advanced (Locally Advanced or Metastatic) Non-small Cell Lung Cancer With METex14 Skipping Alterations or MET Amplification (VISION)
No headline result recorded yet.
- Capmatinib: photosensitivity, use sun protection. Tepotinib: take with food.
- Not recommended for CrCl below 45.
- Dose by Calvert formula using GFR (see the calculators).
- Between Capmatinib, Tepotinib, Capmatinib & tepotinib and the other options, which do you recommend for me, and what about my case would make you choose differently?Why: Guidelines list several reasonable options; the choice turns on details of your tumour, your health and your priorities.
- What is each option trying to achieve: cure, long control, or relief of symptoms, and over what time?Why: The aim shapes how much side effect and disruption is worth accepting.
- How closely do I match the people in GEOMETRY mono-1 and Tepotinib Phase II in NSCLC Harboring MET Alterations (VISION), and does that change what the results mean for me?Why: Trial populations are selected; age, fitness, prior treatment and biomarkers all affect how far results carry.
- What happens if I delay, or decline this step for now? Is the decision reversible?Why: Some decisions can wait for a second opinion or a trial slot; others cannot. Knowing which is part of the choice.
- Does your recommendation follow the current guideline (NCCN Guidelines: Non-Small Cell Lung Cancer), and if it departs from it, why?Why: Departures from guidelines are sometimes right for an individual; they should be explained.
- For my situation (advanced met exon 14, first line or later), which of the standard options do you recommend and why?Why: Guideline options include: Capmatinib (GEOMETRY mono-1) or tepotinib (VISION); platinum-pemetrexed with or without pembrolizumab if the inhibitor is not tolerated or after it.
- Am I a candidate for Capmatinib, Tepotinib, Capmatinib & tepotinib or related drugs, and what side effects should I expect?Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
- How do the results of GEOMETRY mono-1 and Tepotinib Phase II in NSCLC Harboring MET Alterations (VISION) apply to someone like me?Why: Trial populations differ from individual patients; ask how closely you match.
Add these to your appointment list, or take the full question set for this cancer.
MET amplification after osimertinib in EGFR-mutated disease
Osimertinib plus savolitinib (SAVANNAH, SACHI) where available; amivantamab plus chemotherapy; platinum-pemetrexed.
Osimertinib (Tagrisso) is the standard pill for EGFR-mutant lung cancer, now also given after surgery and with chemotherapy or after chemoradiation.
Savolitinib is a Chinese-discovered pill that blocks the MET growth signal, approved in China for lung cancers with a MET exon 14 mutation and being tested worldwide with osimertinib.
A two-armed antibody that blocks EGFR and its escape partner MET, now first-line for EGFR-mutant lung cancer with lazertinib.
- Osimertinib Plus Savolitinib in EGFRm+/MET+ NSCLC Following Prior OsimertinibPhase 2NCT03778229367 peopleevidence 33Tests Osimertinib, SavolitinibA Phase II Study Assessing the Efficacy of Osimertinib in Combination With Savolitinib in Patients With EGFRm+ and MET+, Locally Advanced or Metastatic Non Small Cell Lung Cancer Who Have Progressed Following Treatment With Osimertinib.
No headline result recorded yet.
- A Study of Amivantamab and Lazertinib in Combination With Platinum-Based Chemotherapy Compared With Platinum-Based Chemotherapy in Patients With Epidermal Growth Factor Receptor (EGFR)-Mutated Locally Advanced or Metastatic Non- Small Cell Lung Cancer After Osimertinib FailurePhase 3NCT04988295776 peopleevidence 49Tests AmivantamabA Phase 3, Open-Label, Randomized Study of Amivantamab and Lazertinib in Combination With Platinum-Based Chemotherapy Compared With Platinum-Based Chemotherapy in Patients With EGFR-Mutated Locally Advanced or Metastatic Non-Small Cell Lung Cancer After Osimertinib Failure
No headline result recorded yet.
| Side effect | Any grade | Grade 3+ |
|---|---|---|
| Decreased appetite · FLAURA | 20% | 2.5% |
| Diarrhoea · FLAURA | 58% | 2.2% |
| Fatigue · FLAURA | 21% | 1.4% |
| Rash · FLAURA | 58% | 1.1% |
- Known QT prolongation. Avoid other QT-prolonging drugs where possible; check ECG and correct potassium and magnesium before and during treatment.
- No adjustment for mild or moderate impairment; not studied in severe.
Rates from the label or pivotal trial as recorded on the product page; each grade 3+ figure links to its source.
| Side effect | Any grade | Grade 3+ |
|---|---|---|
| Rash · MARIPOSA, with lazertinib | 86% | 26% |
| Nail toxicity · MARIPOSA, with lazertinib | 71% | 11% |
| Venous thromboembolism · MARIPOSA, with lazertinib | 36% | 11% |
| Infusion-related reaction · MARIPOSA, with lazertinib | 63% | 6% |
- No food effect (intravenous or subcutaneous antibody).
Rates from the label or pivotal trial as recorded on the product page; each grade 3+ figure links to its source.
- Between Osimertinib, Savolitinib and Amivantamab, which do you recommend for me, and what about my case would make you choose differently?Why: Guidelines list several reasonable options; the choice turns on details of your tumour, your health and your priorities.
- What is each option trying to achieve: cure, long control, or relief of symptoms, and over what time?Why: The aim shapes how much side effect and disruption is worth accepting.
- How closely do I match the people in Osimertinib Plus Savolitinib in EGFRm+/MET+ NSCLC Following Prior Osimertinib and A Study of Amivantamab and Lazertinib in Combination With Platinum-Based Chemotherapy Compared With Platinum-Based Chemotherapy in Patients With Epidermal Growth Factor Receptor (EGFR)-Mutated Locally Advanced or Metastatic Non- Small Cell Lung Cancer After Osimertinib Failure, and does that change what the results mean for me?Why: Trial populations are selected; age, fitness, prior treatment and biomarkers all affect how far results carry.
- Which side effects of Osimertinib or Amivantamab are most likely for me, which are reversible, and which would make us stop?Why: The recorded rates below come from labels and trials; your own risk depends on dose, other medicines and your health.
- What happens if I delay, or decline this step for now? Is the decision reversible?Why: Some decisions can wait for a second opinion or a trial slot; others cannot. Knowing which is part of the choice.
- Does your recommendation follow the current guideline (NCCN Guidelines: Non-Small Cell Lung Cancer), and if it departs from it, why?Why: Departures from guidelines are sometimes right for an individual; they should be explained.
- For my situation (met amplification after osimertinib in egfr-mutated disease), which of the standard options do you recommend and why?Why: Guideline options include: Osimertinib plus savolitinib (SAVANNAH, SACHI) where available; amivantamab plus chemotherapy; platinum-pemetrexed.
- Am I a candidate for Osimertinib, Savolitinib, Amivantamab, and what side effects should I expect?Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
- How do the results of Osimertinib Plus Savolitinib in EGFRm+/MET+ NSCLC Following Prior Osimertinib and A Study of Amivantamab and Lazertinib in Combination With Platinum-Based Chemotherapy Compared With Platinum-Based Chemotherapy in Patients With Epidermal Growth Factor Receptor (EGFR)-Mutated Locally Advanced or Metastatic Non- Small Cell Lung Cancer After Osimertinib Failure apply to someone like me?Why: Trial populations differ from individual patients; ask how closely you match.
Add these to your appointment list, or take the full question set for this cancer.
c-Met overexpression, previously treated non-squamous
Telisotuzumab vedotin (LUMINOSITY) after platinum chemotherapy; TeliMET NSCLC-01 versus docetaxel is confirmatory.
Telisotuzumab vedotin (Emrelis) is the first c-MET-directed ADC, approved in 2025 for lung cancer with high c-MET protein.
The first chemotherapy to extend life in prostate cancer (2004), now part of triplet therapy at first metastatic diagnosis.
- Tests Telisotuzumab vedotinPreviously treated c-Met protein-overexpressing, EGFR wild-type non-squamous NSCLC: telisotuzumab vedotin single arm
ORR 28.6% overall; 34.6% in c-Met high, 22.9% in c-Met intermediate.
Objective response rate (independent review) (%): Telisotuzumab vedotin, c-Met high 34.6 (n=78) vs Telisotuzumab vedotin, c-Met intermediate 22.9 (n=83) · source - Tests Telisotuzumab vedotinPreviously treated c-Met-overexpressing, EGFR-wild-type non-squamous NSCLC: telisotuzumab vedotin vs docetaxel
No headline result recorded yet.
- Do not give if bilirubin above ULN, or AST/ALT above 1.5 x ULN with alkaline phosphatase above 2.5 x ULN (treatment-related deaths).
- Between Telisotuzumab vedotin and Docetaxel, which do you recommend for me, and what about my case would make you choose differently?Why: Guidelines list several reasonable options; the choice turns on details of your tumour, your health and your priorities.
- What is each option trying to achieve: cure, long control, or relief of symptoms, and over what time?Why: The aim shapes how much side effect and disruption is worth accepting.
- How closely do I match the people in LUMINOSITY and TeliMET NSCLC-01, and does that change what the results mean for me?Why: Trial populations are selected; age, fitness, prior treatment and biomarkers all affect how far results carry.
- What happens if I delay, or decline this step for now? Is the decision reversible?Why: Some decisions can wait for a second opinion or a trial slot; others cannot. Knowing which is part of the choice.
- Does your recommendation follow the current guideline (NCCN Guidelines: Non-Small Cell Lung Cancer), and if it departs from it, why?Why: Departures from guidelines are sometimes right for an individual; they should be explained.
- For my situation (c-met overexpression, previously treated non-squamous), which of the standard options do you recommend and why?Why: Guideline options include: Telisotuzumab vedotin (LUMINOSITY) after platinum chemotherapy; TeliMET NSCLC-01 versus docetaxel is confirmatory.
- Am I a candidate for Telisotuzumab vedotin, Docetaxel, and what side effects should I expect?Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
- How do the results of LUMINOSITY and TeliMET NSCLC-01 apply to someone like me?Why: Trial populations differ from individual patients; ask how closely you match.
Add these to your appointment list, or take the full question set for this cancer.