mCRC: dual HER2-targeted therapy shows benefit in MyPathway

  • Meric-Bernstam F & al.
  • Lancet Oncol
  • 8 Mar 2019

  • curated by Jim Kling
  • Univadis Clinical Summaries
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Takeaway

  • Pertuzumab plus trastuzumab was well-tolerated and produced objective responses in patients with human epidermal growth factor receptor 2 (HER2)-amplified metastatic colorectal cancer (mCRC).

Why this matters

  • Results come from the MyPathway basket clinical trial, which is evaluating 6 different treatment regimens in a range of solid tumors.

Study design

  • Subset analysis of MyPathway including 57 patients with HER2-amplified mCRC treated with pertuzumab + trastuzumab.
  • Funding: F Hoffmann-La Roche/Genentech.

Key results

  • Median treatment duration, 2.1 months.
  • Disease control rate, 44%.
  • 18 patients had objective response (32%; 95% CI, 20%-45%), with 1 complete response.
  • Median response duration, 5.9 months. 4 patients had responses >1 year.
  • Median PFS, 2.9 months. Median OS, 11.5 months.
  • Outcome differences (KRAS wild-type vs mutated):
    • median PFS, 5.3 vs 1.4 months;
    • median OS, 14.0 vs 8.5 months;
    • objective response rate 40% vs 8%.
  • Treatment-emergent adverse events (AEs) included diarrhea (33%), fatigue (32%), and nausea (30%).
  • 37% of patients experienced grade 3-4 AEs, most commonly hypokalemia (5%) and abdominal pain (5%).
  • 10 patients (18%) had serious AEs, 2 of which were considered treatment-related (chills and infusion-related reaction).

Limitations

  • Nonrandomized.
  • Small sample size.

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