Malignant solid neoplasm, ERBB2-mutated

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Last updated on 2024-07-23:
4 regimens on this page
4 variants on this page


All lines of therapy

Neratinib monotherapy

Regimen

Study Dates of enrollment Evidence
Hyman et al. 2018 (SUMMITHER) Not reported to 2016-12-16 Non-randomized basket trial

Note: the cycle length is not described in the manuscript; the authors have clarified that the cycles are 28 days in length. This trial should not be confused with the one by the same name in multiple myeloma.

Biomarker eligibility criteria

Prior treatment criteria

  • No prior treatment with HER kinase inhibitors

Targeted therapy

Supportive therapy

28-day cycles

References

  1. SUMMIT: Hyman DM, Piha-Paul SA, Won H, Rodon J, Saura C, Shapiro GI, Juric D, Quinn DI, Moreno V, Doger B, Mayer IA, Boni V, Calvo E, Loi S, Lockhart AC, Erinjeri JP, Scaltriti M, Ulaner GA, Patel J, Tang J, Beer H, Selcuklu SD, Hanrahan AJ, Bouvier N, Melcer M, Murali R, Schram AM, Smyth LM, Jhaveri K, Li BT, Drilon A, Harding JJ, Iyer G, Taylor BS, Berger MF, Cutler RE Jr, Xu F, Butturini A, Eli LD, Mann G, Farrell C, Lalani AS, Bryce RP, Arteaga CL, Meric-Bernstam F, Baselga J, Solit DB. HER kinase inhibition in patients with HER2- and HER3-mutant cancers. Nature. 2018 Feb 8;554(7691):189-194. Epub 2018 Jan 31. link to original article dosing details in manuscript have been reviewed by our editors link to PMC article PubMed NCT01953926


Pertuzumab & Trastuzumab

Regimen

Study Dates of enrollment Evidence
Hainsworth et al. 2018 (MyPathway) 2014-2016 Phase 2a

Biomarker eligibility criteria

  • Gene: HER2
  • Alteration: amplification or activation (including exon 20 insertions, deletions around amino acids 755 to 759, and nonsynonymous amino acid substitutions)
  • Acceptable methods of measurement: molecular profiling performed on tissue obtained at the most recent tumor biopsy

Targeted therapy

  • Pertuzumab (Perjeta) as follows:
    • Cycle 1: 840 mg IV once on day 1
    • Cycle 2 onwards: 420 mg IV once on day 1
  • Trastuzumab (Herceptin) as follows:
    • Cycle 1: 8 mg/kg IV once on day 1
    • Cycle 2 onwards: 6 mg/kg IV once on day 1

21-day cycles

References

  1. MyPathway: Hainsworth JD, Meric-Bernstam F, Swanton C, Hurwitz H, Spigel DR, Sweeney C, Burris H, Bose R, Yoo B, Stein A, Beattie M, Kurzrock R. Targeted therapy for advanced solid tumors on the basis of molecular profiles: results from MyPathway, an open-label, phase IIa multiple basket study. J Clin Oncol. 2018 Feb 20;36(6):536-542. Epub 2018 Jan 10. link to original article dosing details in manuscript have been reviewed by our editors PubMed NCT02091141
    1. Update: Sweeney CJ, Hainsworth JD, Bose R, Burris HA, Kurzrock R, Swanton C, Friedman CF, Spigel DR, Szado T, Schulze K, Price R, Malato J, Lo AA, Levy J, Wang Y, Yu W, Meric-Bernstam F. MyPathway Human Epidermal Growth Factor Receptor 2 Basket Study: Pertuzumab + Trastuzumab Treatment of a Tissue-Agnostic Cohort of Patients With Human Epidermal Growth Factor Receptor 2-Altered Advanced Solid Tumors. J Clin Oncol. 2024 Jan 20;42(3):258-265. Epub 2023 Oct 4. link to original article link to original article PubMed


Trastuzumab deruxtecan monotherapy

Regimen

Study Dates of enrollment Evidence
Meric-Bernstam et al. 2023 (DESTINY-PanTumor02) 2020-10-07 to 2022-07-07 Phase 2 (RT)

Antibody-drug conjugate therapy

21-day cycles

References

  1. DESTINY-PanTumor02: Meric-Bernstam F, Makker V, Oaknin A, Oh DY, Banerjee S, González-Martín A, Jung KH, Ługowska I, Manso L, Manzano A, Melichar B, Siena S, Stroyakovskiy D, Fielding A, Ma Y, Puvvada S, Shire N, Lee JY. Efficacy and Safety of Trastuzumab Deruxtecan in Patients With HER2-Expressing Solid Tumors: Primary Results From the DESTINY-PanTumor02 Phase II Trial. J Clin Oncol. 2024 Jan 1;42(1):47-58. Epub 2023 Oct 23. link to original article link to PMC article dosing details in abstract have been reviewed by our editors PubMed NCT04482309


Trastuzumab emtansine monotherapy

Regimen

Study Dates of enrollment Evidence
Li et al. 2018 (MSK 15-335) 2016-03 to 2016-12 Phase 2 basket trial, fewer than 20 pts reported to date

Note: only partial results have been published to date.

Biomarker eligibility criteria

  • Gene: HER2
  • Alteration: various exon 20 insertions, single-base pair substitutions, or other likely activating mutations
  • Acceptable methods of measurement: next-generation sequencing

Antibody-drug conjugate therapy

21-day cycles

References

  1. MSK 15-335: Li BT, Shen R, Buonocore D, Olah ZT, Ni A, Ginsberg MS, Ulaner GA, Offin M, Feldman D, Hembrough T, Cecchi F, Schwartz S, Pavlakis N, Clarke S, Won HH, Brzostowski EB, Riely GJ, Solit DB, Hyman DM, Drilon A, Rudin CM, Berger MF, Baselga J, Scaltriti M, Arcila ME, Kris MG. Ado-trastuzumab emtansine for patients with HER2-mutant lung cancers: results from a phase II basket trial. J Clin Oncol. 2018 Aug 20;36(24):2532-2537. Epub 2018 Jul 10. link to original article dosing details in manuscript have been reviewed by our editors link to PMC article PubMed NCT02675829