Nurse-Specific Recommendations for Adverse Effects of Tepotinib in NSCLC

Guidance for controlling adverse effects in patients with non–small cell lung cancer (NSCLC) and MET exon 14 (METex14) skipping mutations who are treated with tepotinib (Tepmetko) that is geared towards nurses may provide better strategies to for identification and management, according to a poster presentation at the virtual Oncology Nursing Society Congress.

Tepotinib is a MET tyrosine kinase inhibitor used to treat patients with NSCLC with METex14 skipping, which can occur in 3% to 4% of patients.

“As with any anticancer therapy, it is important to promptly identify, prevent, and manage any adverse events,” Terri Alexander, MS, research nurse supervisor at The University of Texas MD Anderson Cancer Center, said during the presentation. “This can help minimize dose modifications and discontinuations and ensure that patients get maximal benefit from therapy. Effective [adverse event] management can also support patient quality of life. Within the multidisciplinary team, nurses play an important role in [adverse event] management.”

Alexander and colleagues developed nurse-specific guidance for the early identification and management of adverse events in patients with NSCLC treated with tepotinib. This guidance was based on the most common adverse events observed in the VISION trial (NCT03511664) in 255 patients with NSCLC and METex14 skipping mutations, in addition to real-world nursing experience.

The adverse events included in the guidance were peripheral edema; creatinine increase; gastrointestinal adverse events like diarrhea, vomiting and nausea; pleural effusion; interstitial lung disease; and liver enzyme elevations. Each adverse event included information on frequency, insights, monitoring, and management

The guidance, for example, details low-grade edema as a common adverse effect even in fit patients, although progressing to established edema can be more difficult to treat. Suitable management approaches for all adverse events include awareness of potential chronology of the adverse event with the observation of early-stage symptoms in routine practice such as skin erosions and weight gain.

“These recommendations can support nurses in timely and effective management of [adverse events] with tepotinib,” Alexander said during the presentation. “Proactive approaches to mitigate [adverse events] may help to improve quality of life. In addition, by increasing time on treatment, [adverse event] management may help improve outcomes for this elderly patient population.”

References

Managing side effects of tepotinib treatment to optimize outcomes for patients with non-small cell lung cancer harboring MET exon 14 skipping: Expert guidance based on clinical experience. Presented at: Oncology Nursing Society 46th Annual Congress. April 20, 22, 27 & 29, 2021. Virtual.