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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?
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How would you plan to use T-Dxd for stage IV HER2-mutant NSCLC?

34 physicians have voted

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3 Answers
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Mednet MemberInvited Expert
Medical Oncology · UCI Health
Answered on

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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Mednet Member
Mednet MemberInvited Expert
Medical Oncology · University of Nebraska Medical Center
Answered on

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 still believe t...

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Mednet Member
Mednet Member
Medical Oncology · Lung Cancer Research Foundation (LCRF)
Answered on

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.

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