HER2m NSCLC an “Exciting Area of Active Investigation,” Says Dr Ticiana Leal

Results from DESTINY-Lung01 have shown promising progression-free survival and overall survival with ongoing research that may lead to a future FDA approval, said Ticiana Leal, MD, associate professor, director of the Thoracic Medical Oncology Program, Department of Hematology and Medical Oncology, Emory University School of Medicine.

Transcript

At ASCO this year, there were critical findings about treatment of HER2-low breast cancer with trastuzumab deruxtecan. Is this an area of exploration in HER2 lung cancer, as well?

Yes, definitely. It's actually a very exciting area of active investigation for patients with advanced non–small cell lung cancer. We know that HER2 mutations identified on NGS [next-generation sequencing], it's an actionable mutation, at least so far, in the studies that have been done. We see HER2 mutations in about 1% to 2% of patients with nonsquamous non–small cell lung cancer.

We have results from the DESTINY-Lung01 trial that looked at T-DXd [trastuzumab deruxtecan] in patients with HER2 mutations advanced non–small cell lung cancer. And in their initial cohort of patients, it really showed that there is significant activity of this agent in patients with advanced non–small cell lung cancer with HER2 mutations. They demonstrated a response rate of about 50%. And overall, really promising progression-free survival, as well as overall survival.

There are some toxicities associated with this agent. Overall, well tolerated, but the main reason for treatment discontinuation in this agent has been pneumonitis. So, I think really understanding some of the toxicities is key. There are ongoing studies also to explore the right dose of T-DXd. And this may lead to an FDA approval for us in the future. The NCCN [National Comprehensive Cancer Network] guidelines has actually already incorporated this in their guidelines as an emerging biomarker.