A Phase II Study of Trastuzumab Emtansine in HER2-Positive Non-Small Cell Lung Cancer

作者：Hotta Katsuyuki^*; Aoe Keisuke; Kozuki Toshiyuki; Ohashi Kadoaki; Ninomiya Kiichiro; Ichihara Eiki; Kubo Toshio; Ninomiya Takashi; Chikamori Kenichi; Harada Daijiro; Nogami Naoyuki; Hirata Taizo; Hinotsu Shiro; Toyooka Shinichi; Kiura Katsuyuki

来源：Journal of Thoracic Oncology, 2018, 13(2): 273-279.

DOI：10.1016/j.jtho.2017.10.032

• Non-small cell lung cancer
• HER2
• trastuzumab emtansine
• precision medicine

Trastuzumab emtansine (T-DM1), an anti-erb-b2 receptor tyrosine kinase 2 (HER2) antibody-drug conjugate, has been shown to significantly improve survival in HER2-positive breast cancer. We report a phase II trial of T-DM1 mono therapy in relapsed NSCLC with documented HER2 positivity (an immunohistochemistry [IHC] score of 3+, both an IHC score of 2+ and fluorescence in situ hybridization positivity, or exon 20 mutation). This study was terminated early because of limited efficacy. The demographic characteristics in the 15 assessable patients were as follows: median age, 67 years; male sex, 47%; performance status of 0 to 1, 80%; HER2 status IHC 3+, 33%; HER status IHC 2+/fluorescence in situ hybridization -positive, 20%; and exon 20 mutation, 47%. The median number of delivered cycles was 3 (range 1-11). One patient achieved a partial response with an objective response rate of 6.7% (90% confidence interval: 0.2-32.0). With a median follow-up time of 9.2 months, the median progression free survival time and median survival time were 2.0 and 10.9 months, respectively. Grade 3 or 4 adverse events included thrombocytopenia (40%) and hepatotoxicity (20%) without any treatment-related deaths. T-DM1 had a limited efficacy for HER2-positive NSCLC in our cohort. Applying the concept of precision medicine to tumors appears challenging; thus, additional molecular approaches are warranted.

• 出版日期2018-2