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HER2-Mutant Advanced Lung Cancer: Pyrotinib After Chemotherapy

By: Justine Landin, PhD
Posted: Monday, October 5, 2020

The tyrosine kinase inhibitor pyrotinib, which targets EGFR, HER2, and HER4, showed antitumor activity in patients with advanced HER2-mutant non–small cell lung cancer (NSCLC) after chemotherapy. According to Caicun Zhou, MD, of Tongji University School of Medicine, Shanghai, and colleagues, this agent also demonstrated an acceptable safety profile. A global, multicenter randomized phase III is being planned and will be underway in the near future. These findings from a multicenter, open-label, single-arm phase II trial were published in the Journal of Clinical Oncology.

“Patients with HER2 mutation account for 1% to 4% of patients with lung adenocarcinoma. Currently, [the] standard of care for patients with advanced HER2-mutant lung cancer is chemotherapy,” the investigators commented.

A total of 60 patients with stage IIIB or IV HER2-mutant NSCLC who had previously received at least 2 lines of platinum-based chemotherapy were enrolled. These patients received oral pyrotinib monotherapy (400 mg/day) throughout 21-day cycles until disease progression, unacceptable toxicity, withdrawal of consent, or investigator decision.

At the median follow-up of 11.7 months, the independent review committee–assessed objective response rate was 30%, all partial responses. The median duration of both the time to response and progression-free survival was 6.9 months. The median overall survival was 14.4 months.

Treatment-related adverse events at grade 3 or higher were observed in 28.3% of patients, with diarrhea being the most common (20%). Two patients had serious adverse effects, leading one patient to discontinue treatment. Three patients died due to adverse events, but no deaths occurred directly due to pyrotinib monotherapy.

Disclosure: For full disclosures of the study authors, see ascopubs.org.



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