Meng Yan, Du Yanping, Liu Xiaolin, Huang Jue, Chen Hanhan, He Chunxia
Department of Medical Oncology, 2nd District, Hainan Cancer Hospital, Hainan, China.
The School of Clinical Medicine, Fujian Medical University, Fuzhou,, China.
Front Immunol. 2025 Aug 12;16:1631768. doi: 10.3389/fimmu.2025.1631768. eCollection 2025.
Patients with ()-mutant non-small cell lung cancer (NSCLC) have poor prognosis. Trastuzumab deruxtecan (T-DXd) is the first targeted therapy approved for the treatment of patients with -mutant metastatic NSCLC, but the evidence in those with non-exon 19/20 mutations is scarce.
We reported treatment information and outcomes of four patients with metastatic NSCLC harboring non-exon 19/20 mutations who were treated with T-DXd.
All the four patients had metastatic lung adenocarcinoma and reached partial response to T-DXd treatment. A 57-year-old female patient with exon 17 V659E mutation received T-DXd as later-line treatment. Treatment was ongoing and the progression-free survival (PFS) had reached 13 months. Three patients received first-line T-DXd treatment. One patient with exon 3 T126A mutation had disease progression after 16-month treatment. The other two patients (one with exon 21 H878Y mutation and one with exon 17 V659E mutation) were continuing T-DXd treatment, both with a PFS of more than 6 months. No interstitial lung disease or grade ≥3 adverse events occurred in these four patients.
The potential of T-DXd in patients with metastatic NSCLC harboring non-exon 19/20 mutations is considerable, which deserves to be validated in large-sample studies.
携带（）突变的非小细胞肺癌（NSCLC）患者预后较差。曲妥珠单抗德瓦鲁单抗（T-DXd）是首个被批准用于治疗携带突变的转移性NSCLC患者的靶向疗法，但关于非19/20外显子突变患者的证据较少。
我们报告了4例携带非19/20外显子突变的转移性NSCLC患者接受T-DXd治疗的治疗信息和结果。
所有4例患者均为转移性肺腺癌，对T-DXd治疗均达到部分缓解。一名57岁的女性患者，携带外显子17 V659E突变，接受T-DXd作为后线治疗。治疗正在进行中，无进展生存期（PFS）已达13个月。3例患者接受一线T-DXd治疗。一名携带外显子3 T126A突变的患者在治疗16个月后病情进展。另外两名患者（一名携带外显子21 H878Y突变，一名携带外显子17 V659E突变）继续接受T-DXd治疗，PFS均超过6个月。这4例患者均未发生间质性肺病或≥3级不良事件。
T-DXd在携带非19/20外显子突变的转移性NSCLC患者中的潜力相当大，值得在大样本研究中进行验证。
