Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China.
Department of Neurosurgery, Suining Municipal Hospital of TCM, Suining, China.
Br J Clin Pharmacol. 2022 May;88(5):2019-2034. doi: 10.1111/bcp.15155. Epub 2021 Dec 21.
Anti-human epidermal growth factor receptor 2 (HER2) therapy is an effective treatment for HER2-positive gastric and breast malignancies. However, the efficacy of HER2-targeted therapy in non-small cell lung cancer (NSCLC) patients with HER2 alterations remains controversial. We searched studies on HER2-targeted therapy in NSCLC patients that reported objective response rate (ORR), disease control rate (DCR) and progressionfree survival (PFS) published from database inception to 30 May 2021. A total of 32 trials involving 958 patients were included. The ORRs of HER2-TKIs targeted therapy, humanised monoclonal antibody, trastuzumab-based treatment and antibody-drug conjugate (ADC) (T-DM1) were 22% (95% CI 11-31), 23% (95% CI 20-65), 26% (95% CI 14-39) and 16% (95% CI _6-37), while that of ADC (DS-8201) was 60% (95% CI 35-85). The DCRs of these groups were 59% (95% CI 49-69), 39% (95% CI _9-88), 63% (95% CI 37-89), 31% (95% CI 4-58) and 87% (95% CI 62-112), respectively. In the subgroup analysis, numerically higher ORRs and DCRs were observed in the poziotinib (38%; 75%) and pyrotinib (35%; 83%) groups. The median PFSs of these groups were 5.51 months, 3.09 months, 4.61 months, 2.65 months and 12.04 months, respectively. HER2-targeted therapy can be considered an acceptable treatment strategy for NSCLC patients with HER2 alterations. In particular, ADC (DS-8201), pyrotinib and poziotinib demonstrated promising anti-tumour activity in HER2-positive NSCLC.
抗人表皮生长因子受体 2（HER2）治疗是治疗 HER2 阳性胃和乳腺癌的有效方法。然而，HER2 靶向治疗在 HER2 改变的非小细胞肺癌（NSCLC）患者中的疗效仍存在争议。我们检索了从数据库建立到 2021 年 5 月 30 日发表的关于 HER2 靶向治疗 NSCLC 患者的报告客观缓解率（ORR）、疾病控制率（DCR）和无进展生存期（PFS）的研究。共纳入 32 项涉及 958 例患者的研究。HER2-TKIs 靶向治疗、人源化单克隆抗体、曲妥珠单抗为基础的治疗和抗体药物偶联物（ADC）（T-DM1）的 ORR 分别为 22%（95%CI 11-31）、23%（95%CI 20-65）、26%（95%CI 14-39）和 16%（95%CI _6-37），而 ADC（DS-8201）的 ORR 为 60%（95%CI 35-85）。这些组的 DCR 分别为 59%（95%CI 49-69）、39%（95%CI _9-88）、63%（95%CI 37-89）、31%（95%CI 4-58）和 87%（95%CI 62-112）。亚组分析显示，poziotinib（38%；75%）和 pyrotinib（35%；83%）组的 ORR 和 DCR 更高。这些组的中位 PFS 分别为 5.51 个月、3.09 个月、4.61 个月、2.65 个月和 12.04 个月。HER2 靶向治疗可被视为 HER2 改变的 NSCLC 患者的一种可接受的治疗策略。特别是 ADC（DS-8201）、pyrotinib 和 poziotinib 在 HER2 阳性 NSCLC 中显示出有希望的抗肿瘤活性。
