Delphi Survey: International consensus on managing peripheral edema associated with MET inhibitors in patients with NSCLC
Context and Objective
Peripheral edema has been identified as a common side effect of MET inhibitors used to treat patients with NSCLC harboring the METΔ14 mutation, typically presenting as mild to moderate in severity. Since the mechanism remains unclear, management relies on empirical approaches, including supportive measures such as compression stockings, specific exercises, massage, limb elevation, and/or diuretic treatment. However, the lack of a standardized definition and guidance on peripheral edema leads to potential misdiagnosis, under-recognition, and inconsistent management.
In this context, the aim of this project is to define the position of healthcare professionals on the use of MET inhibitors and to reach an international consensus on the management of peripheral edema associated with MET inhibitor administration in patients with NSCLC.
This consensus will be established using the Delphi methodology , which is based on a collaborative approach. This method will clarify and harmonize current practices by leveraging the expertise of clinicians involved in the care of these patients.
Methodology and Process
You will have access to an online questionnaire consisting of 32 questions, which should take no more than 15-20 minutes to complete. The Delphi methodology relies on an iterative process: after participating in the first phase, you will be invited to complete a second round of the questionnaire, scheduled for [date to be determined] 2026. This second round will focus only on points requiring further clarification or comments, and you will have access to aggregated results from the first round to guide your responses.
Confidentiality and Expectations
There are no right or wrong answers: we are looking for an accurate description of your actual clinical practice and expert opinion. As the questionnaire addresses three main themes, concise answers directly related to the context are expected. All responses will remain anonymous and treated with strict confidentiality. Only aggregated data will be analyzed and presented.
We sincerely thank you for your participation in this collaborative project, which aims to improve the management of patients with NSCLC haboring MET alterations.
Dr. Claudio Martin, Dr. Paul Paik, Dr. Terufumi Kato, Prof. Daniel Tan, Prof. Frank Griesinger, Prof. Giulia Pasello, Dr. Abdulaziz Aljassim, Dr. Adriano Gonçalves Silva, Dr. Ana Figueiredo, Dr. Dionysis Papadatos-Pastos, Dr. Egbert Smit, Dr. Ingel Demedts, Dr. Maximilian Hochmair, Dr. Maria Silvoniemi, Dr. Nicolas Marcoux, Dr. Ronny Öhman, Dr. Sabine Schmid, Dr. Santiago Viteri Ramirez, Prof. Nick Pavlakis.
This study received institutional support from Merck.
1Niederberger, M. & Spranger, J. Delphi Technique in Health Sciences: A Map. Front Public Health 8, 457 (2020).