Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN
John D. Hainsworth , Ron Bose , Christopher Sweeney , Funda Meric-Bernstam , Herbert Hurwitz , Charles Swanton , Howard A. Burris III, Razelle Kurzrock , Bongin Yoo , Mary Stanley Beattie , Ravindra Gupta , Rajesh D. Patel , Katja Schulze , David R. Spigel
Background: Treatments targeting critical molecular alterations (EGFR, ALK, and ROS1) in NSCLC are highly effective. MyPathway (NCT02091141) is an ongoing, phase 2, multi-basket study evaluating the efficacy of targeted treatment in non-indicated tumor types harboring alterations in the HER2, BRAF, Hedgehog (Hh), or EGFR pathways. Interim results in NSCLC are presented. Methods: Patients with previously treated advanced NSCLC and alterations in the HER2 (amplification and/or mutation), BRAF (V600E or other mutations), Hh (SMO or PTCH-1 mutations), or EGFR (mutations other than known activating mutations) pathways received standard doses of pertuzumab + trastuzumab, vemurafenib, vismodegib, or erlotinib, respectively, until disease progression or unacceptable toxicity. The HER2, BRAF, and Hh cohorts are included in this analysis. The primary endpoint is investigator-assessed objective response rate (ORR, defined as complete response [CR] + partial response [PR]) by RECIST v1.1. Results: As of November 30, 2016, 61 patients with NSCLC and HER2 (n = 36), BRAF (n = 22), or Hh (n = 3) alterations have been treated (median age of 64 years, 49% male, 85% adenocarcinoma, and a median of 2 previous regimens). Median treatment duration was 1.8 (range, 0–21.4) months. Efficacy in the 55 patients with the minimum required follow-up for efficacy analysis is summarized in the table. Conclusions: Targeted therapy is active in patients with previously treated NSCLC harboring BRAF V600E mutations or HER2 alterations (amplifications and/or mutations). These cohorts have been expanded as MyPathway accrual continues. Additional efficacy data and details regarding molecular alterations will be presented. Clinical trial information: NCT02091141
Patients, n | ORR, n (%) | Clinical benefit ratea, n (%) | Durations of objective responses, months | |
---|---|---|---|---|
HER2 alterationsb | 31 | 6 (19) | 10 (32) | < 1+, 3+, 5+, 6, 8, 10 |
BRAF V600E | 14 | 6 (43) (1 CR) | 8 (57) | 4, 4, 5, 5+, 10+, 14 |
BRAF other | 7 | 0 | 1 (14) | NA |
Hh | 3 | 0 | 1 (33) | NA |
+ indicates response is ongoing. aCR + PR + stable disease > 4 months. bHER2 amplified and/or mutated.
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