Efficacy of Combination Chemo-Immunotherapy as a First-Line Treatment for Advanced Non-Small-Cell Lung Cancer Patients With HER2 Alterations: A Case Series

ObjectiveAlthough the treatment of non-small-cell lung cancer (NSCLC) patients with human epidermal growth factor receptor 2 (HER2) alterations has been studied for years, the overall response rate (ORR) of these patients is still unsatisfactory, and more therapeutic strategies are needed. Little is known about the combination of chemo- and immunotherapy in HER2-altered lung cancer treatment.Materials and MethodsWe report five cases of advanced NSCLC with HER2 insertion mutation or amplification treated with immunotherapy combined with chemotherapy as the first-line treatment. The HER2 alteration type, duration of treatment and survival were also analyzed.ResultsThe five advanced NSCLC patients, three with HER2 mutations and two with HER2 amplifications, received chemo-immunotherapy as the first-line treatment. The average patient age was 54.6 years. Three patients were females, and two were males. Among all the patients, only one had a smoking history. The immunotherapies used were as follows: two patients were treated with sintilimab, and three patients were treated with pembrolizumab. Only one patient had squamous carcinoma, and she was also the only patient with a complete response (CR). The progression-free survival (PFS) ranged from 2-12 months, with a median PFS of 8.0 months.ConclusionsChemo-immunotherapy may be a promising first-line treatment option for NSCLC patients with HER2 alterations. Further clinical trials are required to confirm this therapeutic option.

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Full Oral Vinorelbine (NVBO) on D1 and D8 With Carboplatin (CBDCA) as First Line Treatment in Advanced Non-small Cell Lung Cancer (NSCLC) Patients: Preliminary Results of a Prospective Sudy in Nonrandomized Population

CHEST Journal ◽

10.1378/chest.1103753 ◽

2011 ◽

Vol 140 (4) ◽

pp. 956A

Author(s):

Jana Skrickova ◽

Marcela Tomiskova ◽

Lenka Babickova ◽

Tereza Janaskova ◽

Vitezslav Kolek ◽

...

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Small Cell ◽

Line Treatment ◽

Small Cell Lung ◽

First Line ◽

Oral Vinorelbine ◽

Nsclc Patients ◽

First Line Treatment

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Triplets versus doublets, with or without cisplatin, in the first-line treatment of stage IIIB–IV non-small cell lung cancer (NSCLC) patients: a multicenter randomised factorial trial (FAST)

British Journal of Cancer ◽

10.1038/bjc.2011.606 ◽

2012 ◽

Vol 106 (4) ◽

pp. 658-665 ◽

Cited By ~ 10

Author(s):

C Boni ◽

◽

M Tiseo ◽

L Boni ◽

E Baldini ◽

...

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Small Cell ◽

Line Treatment ◽

Small Cell Lung ◽

First Line ◽

Factorial Trial ◽

Nsclc Patients ◽

First Line Treatment

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A3-06: Triplets versus doublets with or without cisplatin in the first-line treatment of stage IIIB-IV non-small cell lung cancer (NSCLC) patients: preliminary results of a multicenter randomized factorial study

Journal of Thoracic Oncology ◽

10.1097/01.jto.0000283109.78009.62 ◽

2007 ◽

Vol 2 (8) ◽

pp. S318 ◽

Cited By ~ 1

Author(s):

Corrado Boni ◽

Editta Baldini ◽

Luca Boni ◽

Marcello Tiseo ◽

Francesco Recchia ◽

...

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Small Cell ◽

Line Treatment ◽

Small Cell Lung ◽

First Line ◽

Preliminary Results ◽

Nsclc Patients ◽

First Line Treatment

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Crizotinib versus pemetrexed-based chemotherapy in patients with advanced ROS1-rearranged non-small cell lung cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.9101 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. 9101-9101

Author(s):

Lan Shen ◽

Shun Lu

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Small Cell ◽

Line Treatment ◽

Small Cell Lung ◽

First Line ◽

Significant Difference ◽

Nsclc Patients ◽

First Line Treatment

9101 Background: ROS1 rearrangement is an important therapeutic target that occurs in approximately 1-2% of patients with non-small cell lung cancer (NSCLC). It has been shown that ROS1-rearranged patients could benefit from crizotinib treatment. However, the efficacy of crizotinib as compared with pemetrexed-based chemotherapy in such patients is unknown. Methods: Advanced ROS1-rearranged NSCLC patients receiving crizotinib or pemetrexed-based chemotherapy as first-line treatment in Shanghai Chest Hospital between August 2010 and December 2017 were retrospectively reviewed. Clinical characteristics, treatments and survival outcomes data were abstracted. Results: Of 77 patients included, 30 patients (39.0%) received crizotinib and 47 patients (61.0%) received pemetrexed-based chemotherapy as their first-line treatment. The median follow-up was 26.8 months. The objective response rate was significantly better with crizotinib than with pemetrexed-based therapy (86.7% vs 44.7%, P < 0.001). The disease control rate wasc 96.7% with crizotinib, as compared with 85.1% with pemetrexed-based therapy (P = 0.140). The median progression-free survival was significantly longer with crizotinib versus pemetrexed-based therapy (18.4 months [95% confidence interval [CI]: 6.8-30.0] vs 8.6 months [95% CI:7.1-10.2], P < 0.001). No significant difference in overall survival (OS) was observed between the two groups (Not reach vs 28.1 months [95% CI:18.7-38.5], P = 0.173). Six patients (20%) in the crizotinib group switched to pemetrexed-based therapy in subsequent lines, while twenty-nine patients (61.7%) in the chemotherapy group crossed over to receive crizotinib after progression. There was no significant difference in median OS between patients who received crizotinib first and those who received pemetrexed-based treatment prior to crizotinib (38.6 months [95% CI: 0-81.0] vs 32.7 months [95% CI:14.3-51.1], P = 0.890). Conclusions: Crizotinib is superior to pemetrexed-based chemotherapy as an initial treatment for advanced ROS1-rearranged NSCLC patients. The sequence of crizotinib treatment and pemetrexed-based chemotherapy does not influence OS.

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