Abstract Background: Primary non-small cell lung cancer (NSCLC) with mesenchymal-epithelial transition factor (MET) gene alterations, including exon 14 skipping mutations and amplification, represents a distinct molecular subtype with unique therapeutic challenges. While multiple tyrosine kinase inhibitor (TKI) strategies have been developed, their comparative efficacy and safety remain systematically unquantified, particularly across different MET alteration types.