Dr. Gandara on Developments in HER2-Targeted Therapies in NSCLC

David R. Gandara, MD, director​,Thoracic Oncology Program, professor, senior advisor to the director​, University of California Davis Comprehensive Cancer Center, discusses recent developments in HER2-targeted therapies as a treatment for patients with non-small cell lung cancer (NSCLC).

While many patients with NSCLC have overexpression of HER2, some also have a driver oncogene associated with a HER2 mutation, particularly a HER2 exon 20 insertion mutation, according to Gandara. Currently, several therapies are in development to target this mutation, such as ado-trastuzumab emtansine (T-DM1; Kadcyla), Gandara says. The agent, which is currently ​FDA approved to treat patients with HER2-positive breast cancer, is being examined in HER2-mutant and HER2-overexpressing NSCLC and has yielded response rates of over 40% in patients with HER2-mutant disease, Gandara explains.

More recently, ​fam-trastuzumab deruxtecan​-nxki (Enhertu) also demonstrated favorable outcomes in this patient population and could potentially be even more active compared with T-DM1, Gandara says. The agent elicitedresponse rates over 60% for patients with HER2-mutant disease, with a progression-free survival of more than 1 year, Gandara adds. As such, these developments are very exciting, Gandara concludes.