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Pyrotinib for HER2-amplified non-small cell lung cancer patient after progression to Afatinib: a case report
Huan Zhao1,2, Hongbo Yang1, Xin Yu1
1Department of Comprehensive Cancer Treatment, Weihai Municipal Hospital, Weihai.
Abstract:
Contrary to the success of antihuman epidermal growth factor receptor 2 (HER2) therapy in HER2-amplified breast cancer, the optimal targeted drug therapy for HER2-amplified lung cancer remains to be determined clinically. In this report, a nonsmoker, Chinese, old, male patient was diagnosed with cT2bN3M0 nonsmall cell lung cancer with genetic testing revealing HER2 amplification. Though the patient received successful microwave ablation, the results of reexamination after two cycles of afatinib monotherapy showed disease progression. Then the treatment regimen was switched to pan-HER inhibitor pyrotinib 400 mg daily, with which the patient remained with stable disease for 9 months. After computed tomography showed tumor enlargement in October 2021, anlotinib was added to the present treatment. This case suggests that pyrotinib may provide a novel effective treatment option for HER2-amplified lung cancer.
Insights
The optimal targeted therapy for HER2-amplified lung cancer is unclear. Pyrotinib showed promise as a treatment option for HER2-amplified lung cancer in a patient case study.
Area of Science:
- Oncology
- Molecular Biology
- Genetics
Background:
- Targeted therapy for human epidermal growth factor receptor 2 (HER2)-amplified cancers is effective in breast cancer but not yet optimized for HER2-amplified lung cancer.
- HER2 amplification is a rare but actionable driver mutation in nonsmall cell lung cancer.
Observation:
- A case of a Chinese, elderly, male, nonsmoker with advanced nonsmall cell lung cancer (NSCLC) and HER2 amplification was reported.
- Initial treatment with afatinib monotherapy led to disease progression after microwave ablation.
- Subsequent treatment with pyrotinib, a pan-HER inhibitor, resulted in stable disease for 9 months.
Findings:
- Pyrotinib demonstrated clinical activity in a patient with HER2-amplified NSCLC who progressed on afatinib.
- Combination therapy with anlotinib was initiated upon disease progression after pyrotinib treatment.
Implications:
- This case highlights pyrotinib as a potential therapeutic option for patients with HER2-amplified lung cancer.
- Further clinical investigation is warranted to establish the efficacy of pyrotinib in this patient population.
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