Topics:
Lung Cancer • Thoracic Malignancies • Medical Oncology • Her2+ • Journal Club ft. NEJM publications
What is your approach to a patient with metastatic lung cancer with HER2 mutant NSCLC who is not a trial candidate?
How are you thinking about sequencing therapies for these patients (IO vs chemo vs T-Dxd)?
Are the data from DESTINY-Lung01 strong enough to warrant earlier use than what was studied?
Answer from: Medical Oncologist at Academic Institution
For newly diagnosed (first line regimen), I would offer either platinum doublet chemotherapy or chemo-immunotherapy (i.e. KN189 regimen) although I might be a little bit more hesitant to do immunotherapy while we figure out the risk factors associated with developing ILD from use of trastuzumab deru...
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Answer from: Medical Oncologist at Academic Institution
I would prefer treating patients with metastatic lung cancer and a HER–2 mutation, who were not trial candidates, with chemoimmunotherapy in the first line setting as long as they do not have any contraindication to those agents. While the data of the DESTINY–Lung01 are impressive, I sti...
Answer from: Medical Oncologist at Community Practice
My usual approach is chemo plus IO with HER2 therapy i.e., T-Dxd as a second line treatment. The DESTINY data are strong but because this is a Phase 2 study, I would prefer to see some Phase 3 data before changing practice.