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HER2-amplified metastatic lung adenocarcinoma responds to fourth-line pyrotinib therapy: A case report
Kan Gong1, Yi Yang1, Huan Huang1
1Cancer Center, Daping Hospital, Army Medical University, Chongqing 400042, P.R. China.
Abstract:
Despite the success of anti-HER2 therapy in patients with breast cancer with HER2 amplification or HER2 overexpression, the results of clinical trials on anti-HER2 therapy for lung cancer have not been satisfactory. The aim of the present study was to report a case of a non-smoker, female patient diagnosed with stage IIIA lung adenocarcinoma harboring HER2 amplification. The disease progressed despite surgery and multiple lines of chemotherapy, plus trastuzumab or lapatinib. The pan-ErbB inhibitor pyrotinib (400 mg/day) was commenced as a fourth-line regimen, and the patient achieved complete response with a time to progression (TTP) of 6 months. After the lung adenocarcinoma progressed, pyrotinib was continued, along with anlotinib and nivolumab. The patient achieved stable disease (SD) status with another 6 months of TTP. The overall survival of the patient was 28 months. Therefore, the present case suggests that the development of novel drugs may provide new and effective therapeutic regimens for lung cancer with HER2 amplification.
Insights
This case study highlights a lung adenocarcinoma patient with HER2 amplification who achieved a complete response to pyrotinib. Further combination therapy extended progression-free survival, suggesting new therapeutic options for HER2-amplified lung cancer.
Area of Science:
- Oncology
- Molecular Biology
- Genomics
Background:
- Anti-HER2 therapies are successful in breast cancer but show limited efficacy in lung cancer.
- HER2 (Human Epidermal growth factor Receptor 2) amplification is a rare but actionable target in lung adenocarcinoma.
- Standard treatments often fail in advanced lung adenocarcinoma with HER2 amplification.
Observation:
- A non-smoker female patient with stage IIIA lung adenocarcinoma was diagnosed with HER2 amplification.
- The patient's disease progressed despite surgery, chemotherapy, and HER2-targeted agents (trastuzumab, lapatinib).
Findings:
- Fourth-line treatment with the pan-ErbB inhibitor pyrotinib resulted in a complete response and 6 months of progression-free survival.
- Subsequent combination therapy with pyrotinib, anlotinib, and nivolumab achieved stable disease for an additional 6 months.
- The patient achieved an overall survival of 28 months.
Implications:
- This case suggests pyrotinib as a potential therapeutic option for lung cancer with HER2 amplification.
- Combination therapies including novel agents may overcome resistance and improve outcomes in HER2-amplified lung cancer.
- Further research into novel drug development is warranted for this subset of lung cancer patients.
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