News in brief: MET inhibitor approved for NSCLC; Pembrolizumab and olaparib benefits pancreatic cancer patient; Consultants urged to act on junior doctor wage theft

3 Feb 2022

MET inhibitor approved for NSCLC

Tepotinib (Tepmetko) has been provisionally approved by the TGA for the treatment of patients with locally advanced or metastatic NSCLC with mesenchymal-epithelial transition (MET) exon 14 skipping alterations.

Tepotinib is a type I adenosine triphosphate (ATP)-competitive small molecule MET inhibitor which has demonstrated durable activity in trials such as the VISION study.

The benefit-risk profile of tepotinib was considered favourable for the therapeutic use approved. However tepotinib is included in the Black Triangle Scheme for the duration of its provisional registration to encourage adverse event reporting.

The recommended dose of tepotinib is 450 mg (two 225 mg tablets) orally once daily with food. Treatment should continue as long as clinical benefit is observed.

Pembrolizumab and olaparib benefits pancreatic cancer patient

An Australian case report has described a profound clinical response to sequential platinum-based chemotherapy, pembrolizumab, and olaparib in a patient with advanced pancreatic adenocarcinoma with a germline BRCA1 mutation and high tumour mutation burden (TMB).

Following molecular analysis which revealed pathogenic BRCA1, KRAS and TP53 mutations, the 76-year-old male patient underwent six cycles of carboplatin and nab-paclitaxel. He also elected to self-fund pembrolizumab from cycle four.

“Five months after commencing maintenance pembrolizumab (10 months after his initial diagnosis), imaging revealed an excellent ongoing response with near-complete resolution of the pancreatic and liver tumors.”

However, oligometastatic progression was evident in a solitary liver metastasis so olaparib was added to the ongoing pembrolizumab.

“Imaging 6 months after the addition of olaparib (16 months after his initial diagnosis) has revealed a complete radiologic response to therapy, with no evidence of residual active malignancy on positron emission tomography or computed tomography or magnetic resonance imaging,” the case report said.

Read more in JCO Precision Oncology.

Consultants urged to act on junior doctor wage theft

Hospital consultants are being urged to help stop public hospital ‘wage theft’ from junior doctors.

An article in MJA Insight says that doctors-in-training are deterred from claiming overtime for fear of being labelled inefficient, incompetent or greedy. Since claims must be signed off by a consultant who usually act as a referee for the junior doctor’s reappointment, these senior clinicians are in a key position to help prevent the chronic underpayment of doctors-in-training, writes Dr Leanne Rowe. They must also support junior staff access to entitlements such extra shift allowances, on call penalties, breaks and training periods, she says.

“Senior consultants must urgently re-examine how they manage legitimate claims for the basic pay entitlements by subordinates, as well as notifying public hospital management of the need for adequate funding for payroll,” she writes.

“Continuing to expect junior doctors to perform significant additional volunteer hours in the presence of many other serious occupational health and safety issues is not only grossly unjust – it’s criminal,” she concludes.

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