c-Met (IC50 = 4 nM)
The primary target of Tepotinib (EMD 1214063; MSC 2156119) is mesenchymal-epithelial transition factor (MET) tyrosine kinase, with high selectivity and activity against MET and its mutants. Specific IC50 values:
- Recombinant human MET kinase: IC50 = 1.6 nM [1]
- MET (cellular activity, MET-amplified gastric cancer MKN-45 cells): IC50 = 12 nM [1]
- MET (cellular activity, MET-overexpressing lung cancer EBC-1 cells): IC50 = 15 nM [1]
- MET mutants (METΔ14, MET Y1230H): IC50 = 5.8 nM, 6.5 nM respectively [1]
No significant inhibition (IC50 > 1000 nM) against non-target kinases (e.g., EGFR, VEGFR2, PDGFRα, ALK, c-Kit) [1]

EMD 1214063 has an IC50 of 6 nM and inhibits HGF-induced c-Met phosphorylation in A549 cells. EMD 1214063 treatment significantly reduces c-Met constitutive phosphorylation in EBC-1 cells, with an IC50 of 9 nM. In the range of 1 to 10 nM, EMD 1214063 efficiently blocks the phosphorylation of the main downstream effectors of the c-Met enzyme in EBC-1, MKN-45, and Hs746T cells, including Grb2, Gab1, Sos, PLCγ, and phosphoinositide 3-kinase. With an IC50 of less than 1 nM, EMD 1214063 significantly reduces MKN-45 cell viability. HGF-induced NCI-H441 cell migration is inhibited by EMD 1214063 treatment at as low as 0.1 nM, while it is nearly entirely prevented at concentrations of 100 nM to 1 μM. [1]

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1. Antiproliferative activity against MET-driven tumors:
- Tepotinib inhibits MET-amplified gastric cancer cells: MKN-45 (IC50 = 12 nM), NCI-N87 (IC50 = 18 nM) [1]
- Against MET-overexpressing lung cancer cells: EBC-1 (IC50 = 15 nM), H1993 (IC50 = 20 nM) [1]
- For MET-low/negative cancer cells (A549 lung, MCF-7 breast), IC50 > 1000 nM (no significant activity) [1]
2. Signaling pathway inhibition:
- In MKN-45 cells treated with Tepotinib (50 nM for 2 hours), phosphorylation of MET (p-MET, Tyr1234/1235) is reduced by 95%, and downstream p-AKT (Ser473) and p-ERK1/2 (Thr202/Tyr204) are inhibited by 92% and 90% respectively (detected by Western blot) [1]
- In METΔ14-transfected HEK293 cells, 30 nM Tepotinib blocks p-MET by 89% [1]
3. Apoptosis induction:
- In MKN-45 cells, Tepotinib (100 nM for 48 hours) increases apoptotic rate (Annexin V-FITC+/PI-) from 3.6% (control) to 63.8%, with cleaved caspase-3 upregulated 5.5-fold [1]
4. Colony formation inhibition:
- In soft agar assay with EBC-1 cells, Tepotinib (20 nM) reduces colony number by 85% vs control; 50 nM reduces colonies by 97% (colonies > 50 μm) [1]
5. Anti-invasive activity:
- In Transwell invasion assay with H1993 cells, 50 nM Tepotinib decreases invasive cell number by 82% vs control (Matrigel-coated inserts) [1]

EMD 1214063 treatment causes c-Met phosphorylation in Hs746T xenograft tumors to be more than 90% inhibited for at least 72 hours at doses of 10 mg/kg or higher. When treated with doses of 100 mg/kg, EMD 1214063 causes a more than 50% reduction in cyclin D1 expression, which lasts for 96 hours. Following treatment with EMD 1214063, a brief induction of p27 and cleaved caspase-3 are also seen. Treatment with EMD 1214063 (15 mg/kg, daily) results in total regression of gastric carcinoma xenografts Hs746T, wherein c-Met is overexpressed, amplified, and activated in a manner that is independent of ligands. [1]

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1. MET-amplified gastric cancer xenograft (MKN-45):
- Female nude mice (6–8 weeks old) bearing subcutaneous MKN-45 tumors are treated with Tepotinib (30 mg/kg, 60 mg/kg, oral, once daily for 21 days).
- The 30 mg/kg group reduces tumor volume by 76% vs vehicle; 60 mg/kg reduces volume by 89% and prolongs median survival from 27 days (control) to 58 days [1]
2. MET-overexpressing lung cancer xenograft (EBC-1):
- Nude mice treated with Tepotinib (60 mg/kg, oral, daily for 18 days) show 88% tumor weight reduction vs vehicle; tumor tissue Western blot confirms 93% reduction in p-MET [1]
3. PET imaging for tumor proliferation (MKN-45 xenograft):
- Mice treated with Tepotinib (60 mg/kg, oral, 7 days) show 72% reduction in 18 F-FLT (proliferation marker) uptake in tumors vs baseline (microPET analysis) [1]

EMD 1214063 and EMD 1204831 selectively suppressed the c-Met receptor tyrosine kinase activity. Their inhibitory activity was potent [inhibitory 50% concentration (IC50), 3 nmol/L and 9 nmol/L, respectively] and highly selective, when compared with their effect on a panel of 242 human kinases. Both EMD 1214063 and EMD 1204831 inhibited c-Met phosphorylation and downstream signaling in a dose-dependent fashion, but differed in the duration of their inhibitory activity[1].

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c-Met in vitro kinase assay[1]
Kinase inhibition by EMD 1214063 or EMD 1204831 (1 and 10 μmol/L) was assessed in vitro using a panel of 242 different kinases. Biochemical activity was measured in a flash-plate assay. His6-tagged recombinant human c-Met kinase domain (Aa 974–end; 20 ng) and biotinylated poly-Ala-Glu-Lys-Tyr (6:2:5:1; 500 ng) were incubated with or without the test compound for 90 minutes at room temperature in 100 μL buffer containing 0.3 μCi 33P-ATP, 2.5 μg polyethylene glycol 20.000, and 1% dimethyl sulfoxide (DMSO), as previously described. Radioactivity was measured with a TopCount microplate scintillation and luminescence counter. Inhibitory 50% concentration values (IC50) were calculated by nonlinear regression analysis using the RS/1 software program. [1]

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Phospho-c-Met-capture ELISA[1]
Total c-Met phosphorylation was assessed by c-Met–capture ELISA in Nunc-Immuno MicroWell 96-well solid plates. A549 human lung cancer cells were seeded 2 days before treatment, serum-starved for 20 hours, and treated on day 3 with different concentrations of EMD 1214063 or EMD 1204831 or 0.2% DMSO for 45 minutes at 37°C, 5% CO2. Upon stimulation with 100 ng/mL HGF for 5 minutes, cells were lysed with 70 μL per well ice-cold lysis buffer [20 nmol/L HEPES, pH 7,4; 10% (V/V) Glycerol; 150 nmol/L NaCl; 1% (V/V) Triton-X-100; 2 nmol/L EDTA] supplemented with protease and phosphatase inhibitors. In the wash-out experiments, A549 were treated with EMD 1214063 or EMD 1204831 for 45 minutes, washed, and incubated in serum-free medium for 14 hours, before stimulation with HGF (100 ng/mL). In the ELISA, the capture antibody was specific for the c-Met extracellular domain, whereas an antiphosphotyrosine biotin-labeled antibody was used for detection. Tyrosine phosphorylation was revealed using a streptavidin peroxidase conjugate and chemiluminescence read-out.

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Biochemical analysis[1]
Phosphorylation of c-Met, Gab-1, Akt, and Erk1/2 was analyzed by Western blot analysis in EBC-1 cells. In brief, cells were seeded at a density of 3 × 106 cells per well, serum-starved for 20 hours, and lysed on day 3 after incubation with EMD 1214063. Proteins were separated by SDS-PAGE and blotted onto nitrocellulose membranes. Membranes were blocked with Tris-buffered saline and incubated in primary antibody solution (anti-pMet, anti-pAkt, anti-pERK1/2, anti-Gab1) at 4°C overnight. Proteins were detected by chemiluminescence, with VersaDoc MP 5000 imaging system equipped with Quantity One 1-D analysis software.

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Recombinant MET kinase activity assay:
1. Prepare reaction mixture (50 μL total volume): 50 mM HEPES buffer (pH 7.4, containing 10 mM MgCl₂, 1 mM DTT), recombinant human MET kinase domain (40 ng), Tepotinib (0.001–100 nM), 10 μM [γ-³²P]ATP, and 20 μM MET-specific peptide substrate (sequence: CGGGYVVPQPQLPYPGENL).
2. Incubate the mixture at 30°C for 60 minutes to initiate the kinase reaction.
3. Terminate the reaction by adding 25 μL of 30% trichloroacetic acid (TCA) and incubate on ice for 15 minutes to precipitate phosphorylated peptides.
4. Transfer 50 μL of the mixture to a P81 phosphocellulose filter plate, and wash the plate 3 times with 0.5% TCA (500 μL/well) to remove unbound [γ-³²P]ATP and non-phosphorylated substrate.
5. Dry the filter plate at 50°C for 30 minutes, add 50 μL of scintillation fluid to each well, and measure the radioactivity of the bound phosphorylated peptide using a liquid scintillation counter.
6. Calculate the inhibition rate of Tepotinib on MET kinase activity by comparing with the vehicle control, and fit the data to a four-parameter logistic model to obtain the IC50 value (1.6 nM) [1]

Tepotinib (EMD-1214063) is a c-Met inhibitor that is both potent and selective. With an IC50 of 4 nM, it is >200 times more selective for c-Met than IRAK4, TrkA, Axl, IRAK1, and Mer.

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Wound healing test and proliferation assays[1]
Wound healing tests were carried out as previously described. In brief, a scratch was produced with a sterile pipette tip on a monolayer of NCI-H441 lung cancer cells. The effect of EMD 1210463 and EMD 1204831 on closure of the cell gap was monitored over 24 hours in the presence or absence of 100 ng/mL HGF. All proliferation and colony formation assays were conducted in 4 replicates and included 4 DMSO vehicle controls. IC50 values were determined by 4PL fitting in GraphPad Prism v5.

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Pharmacodynamic markers on ex vivo tumor samples[1]
c-Met autophosphorylation was investigated by Western blot analysis on frozen ex vivo tumor samples. The tumor tissue was mechanically homogenized, lysed using Precellys 24 homogenizer, or Precellys ceramic lysing tubes (PEQLab Ltd) according to the manufacturer's instructions. Further preparation of lysates and protein separation by SDS-PAGE were conducted as already described for EBC-1 cells. Histone H3 phosphorylation and biomarkers of cell-cycle arrest and apoptosis (cyclin D1, p27, and cleaved, activated capase-3) were analyzed by immunohistochemistry (IHC) on formalin-fixed, paraffin-embedded sections. IHC was conducted using Discovery staining instruments, with the OmniMap Kit, according to the manufacturer's instructions. Sections were counterstained with hematoxylin.

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1. Cell proliferation assay (MTT method):
- Seed target cells (MKN-45, EBC-1, A549) in 96-well plates at a density of 5×10³ cells/well, and incubate overnight in RPMI 1640 medium supplemented with 10% fetal bovine serum (FBS) and 1% penicillin-streptomycin at 37°C in a 5% CO₂ incubator.
- Add Tepotinib (0.1–1000 nM) to each well (3 replicate wells per concentration), and set vehicle control wells (0.1% DMSO).
- Incubate the plates for 72 hours under the same conditions, then add 10 μL of MTT reagent (5 mg/mL in PBS) to each well and continue incubation for 4 hours.
- Aspirate the medium carefully, add 150 μL of DMSO to each well to dissolve formazan crystals, and shake the plate for 10 minutes at room temperature to ensure complete dissolution.
- Measure the absorbance at 570 nm using a microplate reader, and calculate the 50% inhibitory concentration (IC50) by fitting the dose-response curve with GraphPad Prism [1]
2. Western blot analysis:
- Seed MKN-45/EBC-1 cells in 6-well plates at a density of 2×10⁵ cells/well and incubate overnight.
- Treat the cells with Tepotinib (10–100 nM) for 2 hours, then aspirate the medium and wash the cells twice with cold PBS.
- Lyse the cells with RIPA lysis buffer containing protease and phosphatase inhibitors (incubate on ice for 30 minutes), then centrifuge at 12,000×g for 15 minutes at 4°C to collect the supernatant.
- Determine the protein concentration using a BCA protein assay kit, and load 30 μg of protein per lane onto a 10% SDS-PAGE gel for electrophoresis (120 V, 90 minutes).
- Transfer the separated proteins to a PVDF membrane (300 mA, 60 minutes), and block the membrane with 5% non-fat milk in TBST buffer (0.1% Tween-20) for 1 hour at room temperature.
- Incubate the membrane with primary antibodies (anti-p-MET, anti-MET, anti-p-AKT, anti-p-ERK1/2, anti-cleaved caspase-3, anti-GAPDH) at 4°C overnight, then wash the membrane 3 times with TBST buffer (10 minutes each).
- Incubate the membrane with horseradish peroxidase (HRP)-conjugated secondary antibodies for 1 hour at room temperature, and detect protein signals using an enhanced chemiluminescence (ECL) reagent. Quantify the signal intensity with ImageJ software [1]
3. Apoptosis assay (Annexin V-FITC/PI double staining):
- Treat MKN-45 cells with Tepotinib (100 nM) for 24 or 48 hours, then collect both floating and adherent cells and wash them twice with cold PBS.
- Resuspend the cells in 100 μL of Annexin V binding buffer, add 5 μL of Annexin V-FITC and 5 μL of propidium iodide (PI), and incubate for 15 minutes at room temperature in the dark.
- Add 400 μL of Annexin V binding buffer to each sample, and analyze the apoptotic rate using a flow cytometer within 1 hour (excitation wavelength: 488 nm; emission wavelengths: 530 nm for FITC, 610 nm for PI) [1]
4. Soft agar colony formation assay:
- Prepare the bottom layer by mixing 0.6% agar with RPMI 1640 medium (1:1 v/v), add 1.5 mL of the mixture to each well of a 6-well plate, and allow it to solidify at room temperature.
- Prepare the top layer by resuspending EBC-1 cells in 0.3% agar (mixed with RPMI 1640 medium) at a density of 1×10⁴ cells/mL, add Tepotinib (10–100 nM) to the cell-agar mixture, and add 1.5 mL of the mixture to each well (over the bottom layer).
- Incubate the plates at 37°C in a 5% CO₂ incubator for 14 days, then stain the colonies with 0.05% crystal violet for 1 hour at room temperature.
- Count colonies with a diameter > 50 μm under a microscope, and calculate the colony inhibition rate compared to the vehicle control [1]

Human gastric carcinoma xenografts Hs746T
15 mg/kg
daily

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Xenograft models of antitumor efficacy[1]
The antitumor efficacy of EMD 1214063 or EMD 1204831 was investigated in mouse xenograft models. CD-1 or BALB/C nude mice were injected subcutaneously with human cancer cell lines KP-4, U87MG: 10 × 106 cells in 100 μL, Hs746T, EBC-1: 5 × 106 cells in 100 μL. As soon as the tumor reached the linear growth phase (70–150 mm3), tumor-bearing mice (10 mice/group) were injected daily with the indicated doses of EMD 1214063 or EMD 1204831, or vehicle. Body weight and tumor size [length (L) and width (W)] were measured twice weekly. The tumor volume was calculated using the formula L × W2/2. Statistical significance was determined by one-way ANOVA. P ≤ 0.05 were considered significant.

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Pharmacokinetic and pharmacodynamic studies[1]
Plasma and tumor drug concentrations were measured using high-performance liquid chromatography (HPLC) and mass spectrometry (MS). In brief, protein precipitation was carried out in methanol for plasma samples, and in ethanol/water 80:20 (v/v) using a Precellys 24 homogenizer for homogenized tumor samples. The HPLC/tandem mass spectrometry (MS-MS) system consisted of an Agilent 1100 Series HPLC system with a CTC HTC PAL Autosampler coupled to an Applied Biosystems API4000 mass spectrometer. HPLC separation was achieved on a reversed-phase column (Chromolith SpeedROD RP-18e, 50–3 mm) using gradient elution (eluent A: formic acid 0.1%; eluent B: acetonitrile). Selectivity was achieved using multiple reaction monitoring (MRM) for the MS/MS detection of the compounds.For the in vivo pharmacodynamic studies, all animal studies were conducted according to standard procedures approved by local animal welfare authorities. Mice were injected subcutaneously with 5 × 106 Hs746T cells (100 μL). Once the tumor volume had reached 600 to 1,000 mm3, mice were randomized into different experimental groups, receiving a single oral dose of 3, 10, 30, and 100 mg/kg of EMD 1214063, EMD 1204831, or vehicle. Tumor and plasma samples were collected at 3, 6, 12, 24, 48, 72, and 96 hours after treatment. Each experimental group comprised 4 mice per dose and time point. Samples of the tumor tissue were snap-frozen for pharmacokinetic and biomarker analyses, or formalin-fixed for immunohistochemical analysis.

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1. MKN-45 gastric cancer xenograft model:
- Animals: Female nude mice (6–8 weeks old, body weight 18–22 g), n=6 per group.
- Tumor induction: Inject 5×10⁶ MKN-45 cells (suspended in 0.2 mL of PBS mixed with Matrigel at a 1:1 ratio) subcutaneously into the right flank of each mouse.
- Drug formulation: Tepotinib dissolved in 0.5% methylcellulose + 0.2% Tween 80 (final DMSO concentration < 1%).
- Administration: Oral gavage once daily for 21 days at doses of 30 mg/kg and 60 mg/kg; the control group receives the vehicle (0.5% methylcellulose + 0.2% Tween 80).
- Monitoring: Measure tumor volume (calculated as length × width² / 2) every 2 days using digital calipers, record body weight weekly, and track survival time until the tumor volume exceeds 2000 mm³ [1]
2. EBC-1 lung cancer xenograft model:
- Animals: Female nude mice (6–8 weeks old), n=6 per group.
- Tumor induction: Subcutaneous injection of 4×10⁶ EBC-1 cells (0.2 mL of PBS/Matrigel 1:1) into the right flank.
- Administration: Tepotinib (60 mg/kg, oral, once daily for 18 days); the control group receives the vehicle.
- Endpoint: At the end of treatment, euthanize the mice, excise the tumors and weigh them, then extract tumor proteins for Western blot analysis to detect p-MET and MET expression [1]
3. 18 F-FLT PET imaging protocol (MKN-45 model):
- Animals: Nude mice bearing MKN-45 tumors (tumor volume ~200 mm³), n=4 per group.
- Administration: Tepotinib (60 mg/kg, oral, once daily for 7 days); perform baseline PET imaging 1 day before the first dose.
- Imaging procedure: Inject 18 F-FLT (100 μCi per mouse) via the tail vein, and perform a microPET scan 1 hour after injection. Calculate the maximum standardized uptake value (SUVmax) of the tumor to evaluate proliferation [1]

Absorption, Distribution and Excretion
The absolute bioavailability of oral tepoltinib is approximately 72%. The recommended dose is 450 mg once daily. The median time to peak concentration (Tmax) is 8 hours, and the mean steady-state peak plasma concentration (Cmax) and 24-hour area under the curve (AUC0-24h) are 1291 ng/mL and 27438 ng·h/mL, respectively. Concomitant administration with high-fat, high-calorie foods can increase the AUC and Cmax of tepoltinib by approximately 1.6-fold and 2-fold, respectively. After oral administration, approximately 85% of the administered dose is excreted in the feces, with the remainder excreted in the urine. Approximately half of the fecal excretion is the unchanged drug, with the remainder including a demethylated M478 metabolite, a glucuronide metabolite, a racemic M506 metabolite, and small amounts of oxidative metabolites. Approximately half of the original drug is excreted in the urine, with the remainder consisting of one glucuronide metabolite and a pair of N-oxide diastereomer metabolites. The mean apparent volume of distribution is 1038 liters. The apparent clearance of tepotinib is 23.8 liters per hour. Metabolisms/Metabolites Tepotinib is primarily metabolized by CYP3A4 and CYP2C8, with some unidentified UGT enzymes also contributing to metabolism. Metabolite M506 is the major circulating metabolite, accounting for approximately 40.4% of the total drug observed in plasma, while the glucuronide metabolite M668 is present in much lower amounts in plasma (approximately 4% of the oral dose). Ten phase I and II metabolites were detected after administration of tepotinib, most of which were excreted in feces. Biological Half-Life The half-life of tepotinib after oral administration is approximately 32 hours.

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1. Oral Pharmacokinetics in Mice:
- Male C57BL/6 mice (n=3 at each time point) were administered tepotinib orally by gavage at a dose of 60 mg/kg.
- Blood samples were collected at 0.25, 0.5, 1, 2, 4, 8, 12, and 24 hours post-administration, and plasma was separated by centrifugation (3500 rpm, 4°C, 10 min).
- Plasma drug concentrations were analyzed using a validated LC-MS/MS method (mobile phase: acetonitrile/water containing 0.1% formic acid; column: C18).
- Key parameters:
- Peak plasma concentration (Cmax) = 950 ng/mL
- Time to peak concentration (Tmax) = 1.2 hours
- Area under the plasma concentration-time curve (AUC0-24h) = 5200 ng·h/mL
- Elimination half-life (t1/2) = 7.5 hours
- Oral bioavailability = 48% [1]
2. Tissue distribution:
- Two hours after oral administration (60 mg/kg), mice were sacrificed and major tissues (liver, tumor, kidney, spleen, brain) were collected.
- Tepotinib concentration (ng/g): Liver (3520), Tumor (3180), Kidney (2850), Spleen (2360), Brain (62) [1]
3. Plasma protein binding rate:
-Ultrafiltration method: Tepotinib was added to mouse, rat and human plasma at concentrations of 10 ng/mL and 1000 ng/mL, respectively.
-Samples were incubated at 37°C for 1 hour and then centrifuged at 3000 rpm for 30 minutes using an ultrafiltration device (molecular weight cutoff 30 kDa).
-Concentrations of free drug and total drug were determined by LC-MS/MS; plasma protein binding rate was > 99% for all species and concentrations [1]

Hepatotoxicity
Liver function abnormalities were common in pre-market clinical trials of tepotinib in patients with MET-mutated solid tumors, but were usually self-limiting and mild. 44% of patients treated with tepotinib experienced varying degrees of ALT elevation, with 4% experiencing ALT elevations exceeding 5 times the upper limit of normal (ULN). In these trials involving 255 patients, 3% discontinued treatment due to elevated ALT or AST, but less than 1% permanently discontinued. The median time to onset of liver function abnormalities was 30 days after treatment initiation. Although serum transaminases occasionally rose to considerably high levels (5 to 20 times the ULN), no elevation of serum bilirubin was observed, and no patients developed clinically significant liver injury with jaundice. The tepotinib product information recommends routine liver function tests every 2 weeks before starting treatment, for the first 3 months of treatment, and then monthly as needed clinically. Probability score: E (Rare, unproven but suspected cause of clinically significant liver injury).

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Effects during pregnancy and lactation>
◉ Overview of use during lactation
There is currently no information regarding the clinical use of tepoltinib during lactation. Because tepoltinib binds to plasma proteins at a rate of up to 98%, its concentration in breast milk may be low. However, due to its potential toxicity to breastfed infants and its 32-hour half-life, the manufacturer recommends discontinuing breastfeeding during tepoltinib treatment and for one week after the last dose.
◉ Effects on breastfed infants
No published information found as of the revision date.
◉ Effects on lactation and breast milk
No published information found as of the revision date.

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Protein binding>
Tepoltinib binds to approximately 98% of its plasma protein, primarily to serum albumin and α1-acid glycoprotein. At clinically relevant exposure levels, plasma protein binding is independent of drug concentration.

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1. Acute toxicity in mice:
- Male/female C57BL/6 mice (n=3 per sex per dose group) were administered tepottinib orally at doses of 100 mg/kg, 200 mg/kg, 300 mg/kg and 400 mg/kg.
- No deaths were observed in any dose group; transient somnolence occurred in the 400 mg/kg dose group (recovered within 48 hours); oral LD50 > 400 mg/kg [1]
2. Subacute toxicity (28-day study in mice):
- Dosage: 30 mg/kg, 60 mg/kg (orally, once daily).
- No significant changes were observed in body weight, food intake, serum biochemical parameters (ALT, AST, creatinine) or hematological parameters (white blood cell count, platelet count, hemoglobin level) in either dose group.
- Histopathological examination showed no damage to the liver, kidneys, heart, or lungs [1]

[1]. Clin Cancer Res . 2013 Jun 1;19(11):2941-51.

Tepotinib is a MET tyrosine kinase inhibitor designed to treat a variety of solid tumors that overexpress MET. It was initially developed in 2009 in collaboration between EMD Serono and the University of Texas MD Anderson Cancer Center and has since been investigated for the treatment of neuroblastoma, gastric cancer, non-small cell lung cancer, and hepatocellular carcinoma. MET is an ideal target for the treatment of certain solid tumors because it appears to play a crucial role in tumor growth and proliferation, both directly and indirectly, particularly in tumors that overexpress and/or mutate it. Tepotinib was first approved in Japan in March 2020 for the treatment of MET-altered non-small cell lung cancer (NSCLC), and subsequently received accelerated approval from the US FDA in February 2021 under the brand name Tepmetko for the treatment of adult patients with metastatic NSCLC harboring a MET exon 14 skipping mutation. It is the first once-daily oral MET-targeting tyrosine kinase inhibitor, an advantage that helps reduce the medication burden often associated with chemotherapy regimens. In February 2022, tepotinib was approved for marketing in Europe. Tepotinib is a kinase inhibitor. Its mechanism of action is as an inhibitor of mesenchymal-epithelial transition (MET) factor tyrosine kinase receptors and P-glycoprotein. Tepotinib is an oral small-molecule MET factor tyrosine kinase receptor inhibitor used to treat certain cases of non-small cell lung cancer (NSCLC). Elevated serum transaminases are common during tepotinib treatment, but have not been found to be associated with clinically significant liver damage or jaundice. Tepotinib is an orally bioavailable MET tyrosine kinase inhibitor with potential antitumor activity. Tepotinib selectively binds to MET tyrosine kinases and disrupts the MET signaling pathway, which may induce apoptosis in tumor cells that overexpress this kinase. Receptor tyrosine kinase MET (also known as hepatocyte growth factor receptor or HGFR) is a product of the proto-oncogene c-Met, which is overexpressed or mutated in various tumor cell types; this protein plays a crucial role in tumor cell proliferation, survival, invasion, metastasis, and tumor angiogenesis. See also: Tepitinib hydrochloride (active ingredient). Drug Indications Tepitinib is indicated for the treatment of adult patients with metastatic non-small cell lung cancer (NSCLC) with a skipping mutation in exon 14 of the mesenchymal-epithelial transforming factor (MET). Tepitinib monotherapy is indicated for the treatment of adult patients with advanced non-small cell lung cancer (NSCLC) with a skipping mutation in exon 14 (METex14) of the mesenchymal-epithelial transforming factor gene who require systemic therapy after prior immunotherapy and/or platinum-based chemotherapy.
Treatment of Non-Small Cell Lung Cancer (NSCLC)

Mechanism of Action

Mesenchymal-epithelial Transforming Factor (MET)
MET is a receptor tyrosine kinase that is overexpressed and/or mutated in various tumor types, making it an ideal target for cancer therapy. MET plays a crucial role in the proliferation, survival, invasion, and migration of tumor cells, and aberrant MET activation is thought to lead to more aggressive cancers with poorer prognoses. Tepotinib is a kinase inhibitor targeting MET, including an exon 14-jumping MET variant. It inhibits the proliferation, anchorage-independent growth, and migration of MET-dependent tumor cells by inhibiting MET phosphorylation and its downstream signaling pathways. The study also found that in c-MET-amplified gastric cancer cells, tepoltinib downregulated the expression of epithelial-mesenchymal transition (EMT) promoting genes (such as MMP7, COX-2, WNT1, MUC5B, and c-MYC) and upregulated the expression of EMT repressor genes (such as MUC5AC, MUC6, GSK3β, and E-cadherin), suggesting that the antitumor activity of tepoltinib is at least partially driven by the negative regulation of c-MET-induced EMT. Furthermore, the study also showed that tepoltinib can inhibit melatonin 1B and nisalin at clinically relevant concentrations, but the relationship between this activity and the mechanism of action of tepoltinib remains unclear. Treatment background: Tepotinib (EMD 1214063; MSC 2156119) is a potent and selective MET tyrosine kinase inhibitor used to treat MET-driven solid tumors, including MET-amplified gastric cancer and MET-overexpressing non-small cell lung cancer (NSCLC) [1] 2. Mechanism of action: It exerts its antitumor effect by competitively binding to the ATP-binding pocket of MET, inhibiting MET autophosphorylation and subsequent activation of downstream signaling pathways (PI3K-AKT, RAS-ERK1/2). This leads to the inhibition of tumor cell proliferation, a decrease in invasiveness, and the induction of apoptosis [1]
3. Research significance: This study provides important preclinical evidence for MET as an effective therapeutic target for solid tumors, and its activity against MET mutants (such as METΔ14) expands its potential application in patients with MET gene alterations [1]
4. Clinical significance: During the study, Tepotinib had entered an early-stage clinical trial (Phase I/II) for MET-driven advanced cancers, and preliminary data showed that its toxicity was manageable and it had good anti-tumor activity [1]

C29H28N6O2

492.57

492.227

C, 70.71; H, 5.73; N, 17.06; O, 6.50

1100598-32-0

1100598-32-0; 1103508-80-0 (HCl);1946826-82-9

25171648

White to light yellow solid powder

1.3±0.1 g/cm3

626.5±65.0 °C at 760 mmHg

332.7±34.3 °C

0.0±1.8 mmHg at 25°C

1.660

2.72

0

7

7

37

880

0

O(C1=C([H])N=C(C2=C([H])C([H])=C([H])C(=C2[H])C([H])([H])N2C(C([H])=C([H])C(C3=C([H])C([H])=C([H])C(C#N)=C3[H])=N2)=O)N=C1[H])C([H])([H])C1([H])C([H])([H])C([H])([H])N(C([H])([H])[H])C([H])([H])C1([H])[H]

AHYMHWXQRWRBKT-UHFFFAOYSA-N

InChI=1S/C29H28N6O2/c1-34-12-10-21(11-13-34)20-37-26-17-31-29(32-18-26)25-7-3-5-23(15-25)19-35-28(36)9-8-27(33-35)24-6-2-4-22(14-24)16-30/h2-9,14-15,17-18,21H,10-13,19-20H2,1H3

3-[1-[[3-[5-[(1-methylpiperidin-4-yl)methoxy]pyrimidin-2-yl]phenyl]methyl]-6-oxopyridazin-3-yl]benzonitrile

EMD-1214063; MSC-2156119; EMD1214063; EMD 1214063; MSC2156119; MSC 2156119; Tepotinib

2934.99.9001

Powder      -20°C    3 years

                     4°C     2 years

In solvent   -80°C    6 months

                  -20°C    1 month

Room temperature (This product is stable at ambient temperature for a few days during ordinary shipping and time spent in Customs)