Publication-only abstracts (abstract number preceded by an "e"), published in conjunction with the 2019 ASCO Annual Meeting but not presented at the Meeting, can be found online only.
The efficacy of ado-trastuzumab emtansine in patients with HER-2-aberrant non-small cell lung cancer.
Metastatic Non-Small Cell Lung Cancer
Lung Cancer—Non-Small Cell Metastatic
2019 ASCO Annual Meeting
J Clin Oncol 37, 2019 (suppl; abstr e20584)
Author(s): Yang Xia, Xiu Huang, Rui Jin, Wen Li, Huahao Shen; Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
Background: HER-2 aberrations, including gene mutation, gene amplification and protein overexpression, have been considered as oncogenic driver alteration in non-small cell lung cancer. However, the therapeutic effect of Ado-trastuzumab emtansine (T-DM1) is varied in HER-2 altered lung cancer. Thus, we aim to elucidate the efficacy of T-DM1 in treating different subtypes of HER-2 aberrations by integrating and reanalyzing the data from current available literatures. Methods: We sought published articles, case reports and ongoing studies that reported efficacy of T-DM1 in lung cancer with HER-2 aberration. Seven studies met the systematic review criteria. The main outcomes were the overall response rate (ORR). Results: 93 patients with various HER-2 aberrations were identified in 7 studies. HER-2 upregulation was prone to occurred in the patients with smoking history and adenocarcinoma, without gender difference, while HER-2 mutations were more common in female non-smoker with adenocarcinoma. The overall ORR of HER-2 aberration was 19.35%. Subgroup analysis showed the ORR was 35.00% for sole HER-2 mutation, 42.86% for HER-2 gene amplification, 2.78% for HER-2 protein overexpression, respectively. Of note, ORR was only 8.33% for HER-2 upregulation (protein overexpression and/or gene amplification), while ORR was significantly increased to 46.15% upon concomitant HER-2 upregulation and mutation. Furthermore, ORR was 25.00% for overexpression plus mutation, but ORR was up to 80.00% for gene amplification plus overexpression and mutation. Conclusions: T-DM1 is a promising agent targeting to HER-2 mutant or amplified lung cancers and the therapeutic efficiency might be more pronounced upon HER-2 mutation alone with amplification. Additional studies of this agent are warranted.