Why This Study Matters
MET amplification accounts for up to 30% of acquired resistance to EGFR-TKI, especially following third-generation EGFR-TKI treatment, yet precision-targeted therapeutic options remain limited. Early-phase studies demonstrated promising antitumor activity with the MET-TKI dalmelitinib combined with the third-generation EGFR-TKI aumolertinib.
A separate review reports MET amplification in "up to 10% to 25% of patients with EGFR TKI-resistant NSCLC" (external source: JTO Clinical and Research Reports, 2021). Estimates vary by study.
Study Design
This randomized, open-label, phase 3 trial (NCT06110663) assigned patients 1:1 to dalmelitinib-aumolertinib or platinum-based chemotherapy. The primary endpoint was progression-free survival assessed by blinded independent central review per RECIST 1.1. Secondary endpoints included overall survival, objective response rate (ORR), duration of response (DoR), and safety.
314 patients enrolled; 1:1 randomization (156 to dalmelitinib-aumolertinib, 158 to chemotherapy); median follow-up 11.2 months (data cutoff December 10, 2025). Number of sites and dosing in this trial: not specified in source.
Patient Population
Patients had locally advanced or metastatic EGFR-mutated, MET-amplified NSCLC after EGFR-TKI progression. MET amplification was defined by fluorescence in situ hybridization as a mean MET copy number ≥5 or MET/CEP7 ratio ≥2.
Primary Endpoint Results
The hazard ratio for progression or death was 0.60 (95% CI, 0.45 to 0.81; P < 0.001) in favor of dalmelitinib-aumolertinib.
| Measure | Dalmelitinib-aumolertinib (n=156) | Platinum chemotherapy (n=158) |
|---|---|---|
| Median PFS (BICR) | 6.2 months | 4.4 months |
| ORR | 59.6% | 38.6% |
| Median DoR | 9.7 months | 4.4 months |
| Overall survival | Immature | Immature |
The abstract lists ORRs and DoRs as "corresponding" values for the two groups in the order dalmelitinib-aumolertinib, chemotherapy. Median PFS 95% CIs by arm: not specified in source.
Subgroup Analyses
| Subgroup | Result |
|---|---|
| All prespecified subgroups | Not specified in source |
Safety Profile
| Event | Dalmelitinib-aumolertinib | Chemotherapy |
|---|---|---|
| Grade ≥3 treatment-emergent AEs | 50.0% | 51.0% |
| Characteristic toxicity | More hepatic laboratory abnormalities | More hematologic toxicities |
Specific event rates by arm: not specified in source.
Interpretation and Broader Context
The authors conclude that the combination "significantly improved PFS versus chemotherapy, with a manageable safety profile in advanced EGFR-mutated, MET-amplified NSCLC after progression on EGFR-TKI," supporting dual EGFR/MET inhibition as a new treatment option in this biomarker-selected population.
For cross-study context only: in the earlier phase 1b study (HS-10241-102, NCT05430386; ELCC 2026 abstract 31P, as reported by EGFR Channel), patients with any prior EGFR TKI (n = 115) had a confirmed ORR of 48.7% (95% CI, 39.3%-58.2%) and median PFS of 7.4 months (95% CI, 5.6-10.1) (external source: conference abstract as reported by EGFR Channel). These single-arm figures are not comparable to the randomized comparison above.
Limitations
The trial was open-label, and overall survival was immature at the 11.2-month median follow-up, so survival benefit is not yet established. This article is built from the published abstract only; full text was not accessible, and several details (sponsor, number of sites, dosing, subgroup results, event rates by arm and arm-specific confidence intervals) are not specified in the source.