Clinical Scorecard: Hidden Pitfalls in MET Exon 14 Testing

At a Glance

Key Highlights

• MET exon 14 skipping alterations occur in approximately 3–4% of NSCLCs.
• Tissue testing shows high performance; liquid biopsy accuracy is lower.
• RNA testing confirmed exon 14 skipping in 107 out of 114 variants assessed.
• Two large deletions were missed by DNA-based testing but visible in raw data.
• Pass rates for liquid biopsy testing improved from 38% in 2022 to 63% in 2024.

Guideline-Based Recommendations

Diagnosis

• Assay validation should include large deletions, synonymous splice-site variants, and intronic changes.

Management

• Combine DNA- and RNA-based testing when sufficient material is available.

Monitoring & Follow-up

• Participate in external quality assessment programs to improve testing performance.

Risks

• False-negative results are common in liquid biopsy testing, especially for low allele fractions.

Patient & Prescribing Data

Patients with NSCLC undergoing molecular testing for MET exon 14 alterations.

MET exon 14 skipping variants are established predictive biomarkers for targeted therapy.

Clinical Best Practices

• Optimize liquid biopsy assays to improve detection rates.
• Validate bioinformatics pipelines alongside laboratory workflows.

Related Resources & Content

• The Journal of Molecular Diagnostics