www.oncotarget.com Oncotarget, 2019, Vol. 10, (No. 2), pp: 184-197 Research Paper Failures in preclinical and clinical trials of c-Met inhibitors: evaluation of pathway activity as a promising selection criterion Veronica S. Hughes1 and Dietmar W. Siemann1 1University of Florida, Department of Radiation Oncology, UF Health Cancer Center, Gainesville, FL 32608, USA Correspondence to: Dietmar W. Siemann, email:
[email protected] Keywords: cancer; c-Met; small molecule inhibitor; microenvironment; HGF Received: November 01, 2018 Accepted: December 20, 2018 Published: January 04, 2019 Copyright: Hughes et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License 3.0 (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. ABSTRACT C-Met is a frequently overexpressed or amplified receptor tyrosine kinase involved in metastatic-related functions, including migration, invasion, cell survival, and angiogenesis. Because of its role in cancer progression and metastasis, many inhibitors have been developed to target this pathway. Unfortunately, most c-Met inhibitor clinical trials have failed to show significant improvement in survival of cancer patients. In these trials tumor type, protein overexpression, or gene amplification are the primary selection criteria for patient inclusion. Our data show that none of these criteria are associated with c-Met pathway activation. Hence, it is conceivable that the majority of c-Met inhibitor clinical trial failures are the consequence of a lack of appropriate patient selection. Further complicating matters, c-Met inhibitors are routinely tested in preclinical studies in the presence of high levels of exogenous Hepatocyte Growth Factor (HGF), its activating ligand.