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Table of Contents
LETTER TO EDITOR
Year : 2022  |  Volume : 5  |  Issue : 1  |  Page : 195-196

Trastuzumab deruxtecan in HER2-mutant non-small-cell lung cancer


Department of Medical Oncology, Dr. B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India

Date of Submission16-Feb-2022
Date of Decision26-Feb-2022
Date of Acceptance01-Mar-2022
Date of Web Publication31-Mar-2022

Correspondence Address:
Ajay Gogia
Dr. B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi - 110 029
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/crst.crst_84_22

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How to cite this article:
Ganguly S, Gogia A. Trastuzumab deruxtecan in HER2-mutant non-small-cell lung cancer. Cancer Res Stat Treat 2022;5:195-6

How to cite this URL:
Ganguly S, Gogia A. Trastuzumab deruxtecan in HER2-mutant non-small-cell lung cancer. Cancer Res Stat Treat [serial online] 2022 [cited 2022 May 28];5:195-6. Available from: https://www.crstonline.com/text.asp?2022/5/1/195/342447



Li et al.[1] recently reported the impressive response rate of trastuzumab deruxtecan in refractory metastatic HER2-mutant non-small-cell lung cancer (NSCLC). It is, however, pertinent to note that patients with HER2-mutant NSCLC have higher chance of developing brain metastases during the course of treatment, which has been reported in up to 47% cases.[2] Hence, systematic intracranial response assessment is imperative to make any real conclusions about the intracranial penetration and efficacy of the above antibody–drug conjugate.

The study also reports the occurrence of drug-related interstitial pneumonitis in 26% patients (24/91; dose of 6.4 mg/kg), which is higher compared to that observed with the same agent in breast cancer (13.6% at 5.4 mg/kg)[3] or gastric cancer (6.4% at 6.4 mg/kg).[4] Use of a lower dose in breast cancer may partly explain the difference. However, it is more likely that patients with refractory NSCLC have received prior immunotherapy (60/91, 66%) and/or have a prior smoking history (39/91, 43%), which may predispose them to a higher incidence of drug-related interstitial pneumonitis.[5] Exploring biomarkers that may predict the development of pneumonitis and cautious patient selection are crucial to mitigate this clinically significant adverse event.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Li BT, Smit EF, Goto Y, Nakagawa K, Udagawa H, Mazières J, et al. Trastuzumab deruxtecan in HER2 -mutant non–small-cell lung cancer. N Engl J Med 2022;386:241-51.  Back to cited text no. 1
    
2.
Offin M, Feldman D, Ni A, Myers ML, Lai WV, Pentsova E, et al. Frequency and outcomes of brain metastases in patients with HER2 -mutant lung cancers. Cancer 2019;125:4380-7.  Back to cited text no. 2
    
3.
Modi S, Saura C, Yamashita T, Park YH, Kim SB, Tamura K, et al. Trastuzumab deruxtecan in previously treated HER2-positive breast cancer. N Engl J Med 2020;382:610-21.  Back to cited text no. 3
    
4.
Shitara K, Bang YJ, Iwasa S, Sugimoto N, Ryu MH, Sakai D, et al. Trastuzumab deruxtecan in previously treated HER2-positive gastric cancer. N Engl J Med 2020;382:2419-30.  Back to cited text no. 4
    
5.
Skeoch S, Weatherley N, Swift AJ, Oldroyd A, Johns C, Hayton C, et al. Drug-induced interstitial lung disease: A systematic review. J Clin Med 2018;7:356. doi: 10.3390/jcm7100356.  Back to cited text no. 5
    




 

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