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Capmatinib and tepotinib are two pills for the roughly 3% of lung cancers with a MET exon 14 skipping mutation.
Capmatinib and tepotinib are type Ib MET inhibitors that bind only the active conformation of the MET kinase, sparing other kinases. They treat the roughly 3% of non-small-cell lung cancers driven by a MET exon 14 skipping mutation, in both untreated and previously treated patients. Capmatinib (GEOMETRY mono-1: ORR 68% treatment-naive) was approved in 2020 with full approval in 2022; tepotinib (VISION: ORR ~57%) was approved in 2021 with full approval in 2024. Peripheral oedema is the class toxicity and often needs dose adjustment. MET amplification as an EGFR-TKI escape route is a different problem and is instead addressed by amivantamab and MET ADCs. The simple version: test lung adenocarcinomas for MET exon 14 skipping, because two pills work well when it is present.
Highly selective type Ib MET inhibitors. Connects to MET.
1.Capmatinib & tepotinib slips into a pocket on MET.
Background: ADC sequencing, Antigen escape (antigen loss, lineage switch), BCG-unresponsive, Castration-resistant prostate cancer (CRPC), Circulating tumour DNA (ctDNA). Also on OnCo: Resistance: how tumours escape each drug class · Lines of therapy.
Oral, self-administered, so it is a Part D drug: covered through a stand-alone Part D plan or Medicare Advantage drug benefit, usually on the specialty tier with 25 to 33% coinsurance until the annual cap ($2,000 in 2025, $2,100 in 2026). Both Tabrecta and Tepmetko are Part D specialty drugs.
Covered for FDA-labelled and NCCN-listed uses, but almost always behind prior authorisation confirming diagnosis, biomarker and line of therapy; dispensed through a specialty pharmacy. MET exon 14 skipping by an approved test.
Part D out-of-pocket capped at $2,000 (2025) / $2,100 (2026). Medicare patients cannot use manufacturer co-pay cards; charity funds (PAN, HealthWell, CancerCare) and the Extra Help subsidy are the routes.
Sources: Medicare.gov: Drug coverage (Part D) · Medicare.gov: Costs for Medicare drug coverage (annual out-of-pocket cap). Not medical or financial advice; verify with your plan.
Sources: NICE TA789 · SMC advice: tepotinib. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.
| Region | Year | Indication |
|---|---|---|
| US | 2020 | MET exon 14 skipping NSCLC (capmatinib; tepotinib 2021) |
| EU | 2022 | Tepmetko 2022; Tabrecta 2022 |
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Query for this drug: (TITLE:"Capmatinib & tepotinib" OR ABSTRACT:"Capmatinib & tepotinib" OR TITLE:"Tabrecta" OR ABSTRACT:"Tabrecta" OR TITLE:"Tepmetko" OR ABSTRACT:"Tepmetko") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Capmatinib & tepotinib, not a curated reading list.
Shares VISION (tepotinib), MET exon 14 skipping mutation, Merck KGaA (EMD Serono), MET exon 14 and MET-amplified non-small-cell lung cancer.
Shares MET exon 14 skipping mutation, MET exon 14 and MET-amplified non-small-cell lung cancer, MET, Receptor tyrosine kinase activation.
Shares GEOMETRY mono-1, MET exon 14 skipping mutation, MET exon 14 and MET-amplified non-small-cell lung cancer, MET.
Shares GEOMETRY mono-1, MET exon 14 and MET-amplified non-small-cell lung cancer, MET, Novartis.
Shares MET exon 14 and MET-amplified non-small-cell lung cancer, MET, Non-small-cell lung cancer.
Shares GEOMETRY mono-1, MET exon 14 and MET-amplified non-small-cell lung cancer, MET, Receptor tyrosine kinase activation.
Shares VISION (tepotinib), MET exon 14 and MET-amplified non-small-cell lung cancer.
Shares MET exon 14 skipping mutation, MET, Non-small-cell lung cancer.