Lenz Discusses the Prognostic and Predictive Value of HER2 Gene Expression in KRAS Wild-Type mCRC

Welcome to OncLive On Air^®! I’m your host today, Ashling Wahner.

OncLive On Air is a podcast from OncLive^®, which provides oncology professionals with the resources and information they need to provide the best patient care. In both digital and print formats, OncLive covers every angle of oncology practice, from new technology to treatment advances to important regulatory decisions.

In today’s episode, we had the pleasure of speaking with Heinz-Josef Lenz, MD, FACP, about the prognostic and predictive value of HER2 gene expression for patients with KRAS wild-type metastatic colorectal cancer (mCRC). Lenz is a professor in the Department of Medicine and the Department of Preventive Medicine in the Division of Oncology at the University of Southern California (USC) Keck School of Medicine in Los Angeles. He also serves as the associate director of Clinical Research, chair of the Gastrointestinal Oncology Program, and co-director of the Colorectal Center at the USC Norris Comprehensive Cancer Center.

According to data from a retrospective analysis of the patient population from the phase 3 CALGB/SWOG 80405 trial (NCT00265850), patients with mCRC with high HER2 expression experienced progression-free survival (PFS) and overall survival (OS) benefit regardless of treatment with bevacizumab (Avastin) or cetuximab (Erbitux). Notably, the association between HER2 expression and survival outcomes was nonlinear, with increases in OS, PFS, and overall response rate plateauing after reaching the median value of HER2 expression. Furthermore, the study found that among patients with high HER2 expression, treatment with cetuximab plus chemotherapy was associated with improved OS vs bevacizumab plus chemotherapy. Conversely, patients with low HER2 expression achieved superior PFS and OS with the bevacizumab regimen vs the cetuximab regimen.

In our exclusive interview, Lenz discussed critical gaps in knowledge regarding the role of HER2 expression in mCRC, expanded on the link between HER2 expression and responses with bevacizumab- vs cetuximab-based regimens, and emphasized the potential utility of HER2 expression to guide treatment decision-making in this setting.

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