Sie sind bereits registriert?
Loggen Sie sich mit Ihrem Universimed-Benutzerkonto ein:
Sie sind noch nicht registriert?
Registrieren Sie sich jetzt kostenlos auf universimed.com und erhalten Sie Zugang zu allen Artikeln, bewerten Sie Inhalte und speichern Sie interessante Beiträge in Ihrem persönlichen Bereich
zum späteren Lesen. Ihre Registrierung ist für alle Unversimed-Portale gültig. (inkl. allgemeineplus.at & med-Diplom.at)
Trastuzumab Deruxtecan Is Active in HER2-Mutant NSCLC
HER2 mutations drive roughly 3% of nonsquamous non–small-cell lung cancers (NSCLC) and are often seen in patients who are slightly younger, female, and never-smokers. This subtype also carries a poor prognosis and an increased incidence of brain metastasis. These patients typically receive standard chemotherapy and/or immunotherapy.
Trastuzumab deruxtecan is a HER2 antibody–drug conjugate. In the DESTINY-Lung01 trial, investigators assessed the efficacy and safety of trastuzumab deruxtecan in 91 patients with HER2-mutant NSCLC who had relapsed on or were refractory to standard therapy. Centrally confirmed objective response occurred in 55% of the patients (95% CI, 44–65). A disease control rate of 92.3% was observed, with a decrease in tumor size in most patients. The median duration of response was 9.3 months (95% CI, 5.7–14.7). Median progression-free survival was 8.2 months (95% CI, 6.0–11.9), and median overall survival was 17.8 months (95% CI, 13.8–22.1).
The safety profile was generally consistent with those from previous studies: grade 3 or higher drug-related adverse events occurred in 46% of patients, most commonly neutropenia (in 19%). Drug-related interstitial lung disease (ILD) or pneumonitis occurred in 26.4% but was grade 1/2 in most. Four patients developed grade 3 lung injury, and two died from ILD.
Comment
Clearly, trastuzumab deruxtecan has activity against HER2-mutated NSCLC. Until there is better understanding of its safety profile, this is likely a second-line drug. In addition, this study again underscores the importance of broad, upfront molecular testing in NSCLC.
Citation(s)
Author:
Li BT et al.
Title:
Trastuzumab deruxtecan in HER2-mutant non–small-cell lung cancer.
Source:
N Engl J Med
2021
Sep
18; [e-pub].
(Abstract/FREE Full Text)
Empfohlen von
Jyoti D. Patel, MD, FASCO