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Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research

3102 - A phase II study of trastuzumab monotherapy in pretreated patients with non-small cell lung cancers (NSCLCs) harboring HER2 alterations: HOT1303-B trial

Date

20 Oct 2018

Session

Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research

Topics

Targeted Therapy;  Immunotherapy

Tumour Site

Presenters

Ichiro Kinoshita

Citation

Annals of Oncology (2018) 29 (suppl_8): viii493-viii547. 10.1093/annonc/mdy292

Authors

I. Kinoshita1, T. Goda1, K. Watanabe2, M. Maemondo3, S. Oizumi4, T. Amano5, Y. Hatanaka6, Y. Matsuno7, H. Nishihara8, H. Asahina9, T. Harada10, K. Goto11, H. Isobe12, M. Nishimura13, H. Dosaka-Akita1

Author affiliations

  • 1 Department Of Medical Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, 060-0812 - Sapporo/JP
  • 2 Department Of Respiratory Medicine, Miyagi Cancer Center, 981-1293 - Natori/JP
  • 3 Division Of Respiratory Medicine, Allergy, And Rheumatology., Iwate Medical University School of Medicine, 0208505 - Morioka/JP
  • 4 Department Of Respiratory Medicine, National Hospital Organization Hokkaido Cancer Center, 060-8638 - Sapporo/JP
  • 5 Clinical research And Medical Innovation Center, Hokkaido University Hospital, 060-8638 - Sapporo/JP
  • 6 Research Division Of Genome Companion Diagnostics, Hokkaido University Hospital, 060-8638 - Sapporo/JP
  • 7 Department Of Surgical Pathology, Hokkaido University Hospital, 060-8638 - Sapporo/JP
  • 8 Genomics Unit, Keio Cancer Center, Keio University School of Medicine, 060-8638 - Sapporo/JP
  • 9 First Department Of Medicine, Hokkaido University Hospital, 060-8638 - Sapporo/JP
  • 10 Department Of Respiratory Medicine, JCHO Hokkaido Hospital, 062-8618 - Sapporo/JP
  • 11 Department Of Thoracic Oncology, National Cancer Center Hospital East, 277-8577 - Kashiwa/JP
  • 12 Department Of Medical Oncology, KKR Sapporo Medical Center, sapporo/JP
  • 13 Department Of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, 060-0812 - Sapporo/JP
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Resources

Abstract 3102

Background

About 5% of NSCLCs have high level of overexpression and/or amplification of HER2 or its mutations, mostly exon 20 insertions. Retrospective studies suggest some activity of a Her2-targeted antibody, trastuzumab, for HER2-altered NSCLCs. However, no clinical trial data of trastuzumab monotherapy for HER2-altered NSCLCs are available so far.

Methods

HOT1303-B was a multicenter, single-arm phase II study of trastuzumab for NSCLC patients who were pretreated with two or more regimens and had HER2-altered tumors (IHC 3+ or IHC 2+/dual color in situ hybridization [DISH] +, and/or presence of mutations) identified by a HER2 screening study HOT1303-A and a nationwide genomic screening study LC-SCRUM-Japan. Eligible patients (pts) were treated with trastuzumab 6 mg/kg every 3 weeks (loading dose 8 mg/kg). The primary endpoint was the overall response rate (ORR) using RECIST v1.1. This study required ten pts, with ORR of 10% considered non-promising and 40% promising (one-sided alpha = 0.10; beta = 0.2).

Results

Ten pts were recruited in this trial. The median age was 59 (range 44-74), three pts were female, three pts were never smokers, nine pts had performance status 0-1, and all had adenocarcinomas. The median lines of prior systemic therapy were 3 (range 2-6). There were two pts with IHC 3+, one pt with IHC 2+/DISH +, five pts with exon 20 insertions (four A755_G776insYVMA and one G776>VC) and two pts with S310F mutations without overlapping cases. ORR was 0% (95% CI, 0-26%). Disease control ratio (DCR) was 70% (95% CI, 39-91%). Median progression-free survival was 5.2 months (95% CI, 1.4-6.3). Grade ≥ 3 adverse events occurred only in a patient with grade 3 pneumonitis, which was judged as organizing pneumonia related with tumor progression. OS data will be presented at the meeting.

Conclusions

Trastuzumab monotherapy did not produce response for HER2-altered NSCLCs in this cohort, although DCR and PFS seemed favorable for the heavily treated pts. Additional approaches including combination therapy are required for HER2-targeted therapy using trastuzumab.

Clinical trial identification

UMIN000012551.

Legal entity responsible for the study

Hirotoshi Dosaka-Akita.

Funding

Ministry of Health, Labor and Welfare, Japan.

Editorial Acknowledgement

Disclosure

I. Kinoshita: Honoraria: Chugai Phama, Novartis. M. Maemondo: Advisory role: Chugai Pharma, AstraZeneca, Boehringer Ingelheim, MSD, Bristol-Myers Squibb Japan, Ono Pharmaceutical, Pfizer, Novartis, Taiho Pharmaceutical, Lilly Japan; Research funding: Boehringer Ingelheim, Chugai Pharma, AstraZeneca, Novartis, Sanofi, MSD, Lilly Japan. S. Oizumi: Honoraria: AstraZeneca Japan, Lilly Japan; Research funding: Kyowa Hakko Kirin, Pfizer, BMS UK, Ono Pharmaceuticals. Y. Hatanaka: Advisory role: GeneticLab, Medicinal Chemistry Pharmaceutical Co.; Speakers' bureau: Merck Sharp & Dohme, Chugai Pharma, Pfizer; Honoraria: Ono Pharmaceutical, AstraZeneca KK.; Research funding: Roche, Taiho Pharmaceutical, Eisai, Merck Sharp & Dohme. T. Harada: Honoraria: Taiho Pharmaceutical, AstraZenea KK, Boehringer Ingelheim, Hisamitsu Pharmaceutical. K. Goto: Advisory role: Otsuka; Honoraria: Daiichi Sankyo, Bristol-Myers Squibb, AstraZeneca, Pfizer, Chugai Pharma, Taiho Pharmaceutical, Ono Pharmaceutical, Ono Pharmaceutical, Novartis, Lilly, Boehringer Ingelheim, Quintiles, Merck Serono, SRL Diagnostics, Life Technologies, F. Hoffmann La Roche AG, MSD, AbbVie, RIKEN GENESIS, Nippon Kayaku; Research funding: MSD, AstraZeneca, Taiho Pharmaceutical, Chugai Pharma, Boehringer Ingelhiem, Ono Pharmaceutical, OxOnc, Sumitomo Dainippon, Takeda, Novartis, Daiichi Sankyo, Kyowa Hakko Kirin, Astellas Pharma, Eisai, Lilly, Pfizer, Riken Genesisi, Bristol-Myers Squibb, Merck Serono, Abbvie, Ignyta. H. Isobe: Speakers' Bureau: Chugai Pharma, Bristol-Myers Squibb Japan, Pfizer. All other authors have declared no conflicts of interest.

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