INSIGHT 2：MET 扩增耐药时 Tepotinib + 奥希替尼

类型: 论文 发表日期: 2024-08 入库日期: 2026-05-21 来源: The Lancet Oncology 标签: EGFR L858R, 奥希替尼耐药, MET扩增, Tepotinib, 再活检

Citation

Wu YL, et al. Tepotinib plus osimertinib in patients with EGFR-mutated non-small-cell lung cancer with MET amplification following progression on first-line osimertinib (INSIGHT 2): a multicentre, open-label, phase 2 trial. The Lancet Oncology. 2024. DOI: 10.1016/S1470-2045(24)00270-5

Why this is in CCL

Mom’s baseline panel did not show MET amplification, but MET amplification is a common acquired resistance mechanism after osimertinib. This paper supports why repeat NGS at progression matters.

Key takeaways

• Population: EGFR-mutated NSCLC with MET amplification after first-line osimertinib progression.
• Strategy: continue EGFR blockade with osimertinib while adding MET inhibition.
• The trial is molecularly selected; benefit depends on confirming MET amplification.

Practical relevance

• Strongly supports re-biopsy or high-quality plasma/tissue NGS if there is clear progression.
• If MET amplification appears, a MET inhibitor plus continued EGFR inhibition becomes a rational targeted option to discuss.
• If MET is absent, this paper should not be over-applied.