Jody C Chuang1, Henning Stehr2, Ying Liang3, Millie Das4, Jane Huang5, Maximilian Diehn6, Heather A Wakelee5, Joel W Neal7. 1. Division of Hematology and Oncology, Stanford Hospital and Clinics, Stanford, California. 2. Stanford Cancer Institute, Stanford University, Stanford, California. 3. Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, People's Republic of China. 4. Department of Medicine, Division of Oncology, Stanford University School of Medicine, Stanford, California; Palo Alto Veterans Administration Health Care System, Palo Alto, California. 5. Department of Medicine, Division of Oncology, Stanford University School of Medicine, Stanford, California. 6. Stanford Cancer Institute, Stanford University, Stanford, California; Department of Radiation Oncology, Stanford University, Stanford, California. 7. Department of Medicine, Division of Oncology, Stanford University School of Medicine, Stanford, California. Electronic address: jwneal@stanford.edu.
Abstract
INTRODUCTION: Erb-b2 receptor tyrosine kinase 2 gene (ERBB2) (also called HER2) has long been recognized as an oncogenic driver in some breast and gastroesophageal cancers in which amplification of this gene confers sensitivity to treatment with Erb-b2 receptor tyrosine kinase 2 (ERBB2)-directed agents. More recently, somatic mutations in ERBB2 have been reported in 1% to 2% of patients with lung adenocarcinoma. Previous case series have suggested clinical tumor responses using anti-ERBB2 small molecules and antibody therapies. METHODS: Here we report the outcomes of nine patients with metastatic lung adenocarcinoma with ERBB2 mutations being treated with ERBB2-targeted therapies. RESULTS: Four of the nine patients had response to targeted therapies, with durations of response ranging from 3 to 10 months. We identified a de novo phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha gene (PIK3CA) mutation and ERBB2 copy number gain as potential resistance mechanisms. CONCLUSIONS: We showed patients with ERBB2-mutated lung adenocarcinoma can respond to targeted therapies, and we identified potential resistance mechanisms upon progression to targeted therapies.
INTRODUCTION:Erb-b2 receptor tyrosine kinase 2 gene (ERBB2) (also called HER2) has long been recognized as an oncogenic driver in some breast and gastroesophageal cancers in which amplification of this gene confers sensitivity to treatment with Erb-b2 receptor tyrosine kinase 2 (ERBB2)-directed agents. More recently, somatic mutations in ERBB2 have been reported in 1% to 2% of patients with lung adenocarcinoma. Previous case series have suggested clinical tumor responses using anti-ERBB2 small molecules and antibody therapies. METHODS: Here we report the outcomes of nine patients with metastatic lung adenocarcinoma with ERBB2 mutations being treated with ERBB2-targeted therapies. RESULTS: Four of the nine patients had response to targeted therapies, with durations of response ranging from 3 to 10 months. We identified a de novo phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha gene (PIK3CA) mutation and ERBB2 copy number gain as potential resistance mechanisms. CONCLUSIONS: We showed patients with ERBB2-mutated lung adenocarcinoma can respond to targeted therapies, and we identified potential resistance mechanisms upon progression to targeted therapies.
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