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How would you approach frontline treatment of a patient with metastatic non-squamous NSCLC with ERBB2 amplification and PD-L1 > 50%?

In the absence of a frontline clinical trial, would you treat with carboplatin+pemetrexed+pembrolizumab or consider IMPOWER 150 or other?
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How would you approach frontline treatment of a patient with metastatic non-squamous NSCLC with ERBB2 amplification and PD-L1 > 50%?

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3 Answers
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Medical Oncology · Albert Einstein College of Medicine at Montefiore Medical Center
Answered on

This interesting case brings up how to separate in our work fact from fiction. We are presented with a case of a patient with metastatic non-squamous non-small cell lung cancer with a PD-L1 TPS score of 55% and ERBB2 amplification by Foundation One testing.

What is the right approach? Standard chemo/...

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Medical Oncology · Cedars-Sinai Medical Center
Answered on

Regarding front line therapy for ERBB2/HER2 alterations for NSCLC in the era of immune checkpoint inhibition, limited data is available. The most extensive data presented is based on ERBB2 exon 20 insertion mutations rather than amplification in NSCLC. Mazieres and colleagues published on the effica...

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Medical Oncology · Perelman School of Medicine at the University of Pennsylvania
Answered on

Very erudite discussions by both @Dr. First Last and @Dr. First Last. I've very little to add. I just want to remind readers that this patient would have been eligible technically for either KN 024 or KN 189 since neither study explicitly excluded ERBB2/HER2 abnormalities, only EGFR and ALK. Clinica...

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