Treatment of Advanced or Metastatic Non-Small Cell Lung Cancer with an ERBB2 (HER2) Mutation at Disease Progression

Clinical Scenario

This protocol addresses patients with advanced or metastatic non-small cell lung cancer (NSCLC) in whom an activating ERBB2 (HER2) mutation has been identified and whose disease has progressed. ERBB2 mutations occur in a small but meaningful subset of NSCLC cases and confer responsiveness to anti-HER2 targeted therapy.

Molecular Context

Up to 5% of NSCLC cases may harbour an ERBB2 (HER2) mutation. Activating mutations in ERBB2 identify a population for whom anti-HER2 targeted therapy is clinically relevant, distinguishing this subgroup from NSCLC patients without this alteration.

Subsequent Therapy Approach

At the time of disease progression, the protocol designates preferred anti-HER2 targeted therapy options — along with additional agents considered useful in certain circumstances. The complete selection criteria and regimen details are in the full protocol.

Instant Access to Structured Evidence-Based Regimens

References

Up to 5% of NSCLC may have a mutation in ERBB2 (HER2). Activating mutations in ERBB2 are associated with responsiveness to anti-HER2 targeted therapy agents.

At the time of disease progression, fam-trastuzumab deruxtecan-nxki, zongertinib (if not previously given), or sevabertinib are recommended as preferred subsequent therapy options, while ado-trastuzumab emtansine is designated as "Useful in certain circumstances."

View source ↗