Dataset Information

First-line immunotherapy or angiogenesis inhibitor plus chemotherapy for HER2-altered NSCLC: a retrospective real-world POLISH study.

ABSTRACT:

Background

There have been no comprehensive large-scale studies that have evaluated the benefits of chemotherapy-based regimens in addressing HER2-altered advanced non-small-cell lung cancer (NSCLC) in a first-line setting. Data on HER2 alteration subtypes and concomitant alterations are also limited. Accordingly, our retrospective, real-world POLISH study assesses the efficacy of first-line chemotherapy alone (C) as well as combinations with immune checkpoint inhibitors (C + I) or angiogenesis inhibitors (C + A) for HER2-altered NSCLC; molecular features are also reported.

Methods

HER2-altered NSCLC patients who received a first-line treatment between November 2015 and September 2021 were screened. Patients treated with C, C + I, or C + A were included in our final efficacy analysis. Progression-free survival (PFS) was compared between the subgroups. A Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis was performed to evaluate concomitant alterations.

Results

A total of 293 patients were screened, with an identification of HER2 amplification and 37 distinct HER2 mutations, and 210 cases treated with C, C + I, or C + A were ultimately included. C + A achieved longer PFS than C (5.63 vs 4.03 months, hazard ratio: 0.64, 95% confidence interval [CI]: 0.46-0.88, p = 0.006). C + I did not improve median PFS compared to C + A or C (both p > 0.05), despite the programmed cell death ligand-1 (PD-L1) expression or tumor mutational burden. KEGG analysis revealed that concomitant upregulation of PI3 K/AKT pathway signaling was common in HER2-altered NSCLC.

Conclusion

Chemotherapy plus angiogenesis inhibitors may yield a greater survival benefit than chemotherapy alone in a first-line setting for HER2-altered NSCLC, whereas an immune-based combination therapy may not be superior to a sole chemotherapy regimen. Activation of PI3 K/AKT signaling may mediate immunosuppression in HER2-altered NSCLC.

SUBMITTER: Yang G

PROVIDER: S-EPMC8894956 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

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Publications

First-line immunotherapy or angiogenesis inhibitor plus chemotherapy for <i>HER2</i>-altered NSCLC: a retrospective real-world POLISH study.

Yang Guangjian G Yang Yaning Y Liu Runze R Li Weihua W Xu Haiyan H Hao Xuezhi X Li Junling J Xing Puyuan P Zhang Shuyang S Ai Xin X Xu Fei F Wang Yan Y

Therapeutic advances in medical oncology 20220302

<h4>Background</h4>There have been no comprehensive large-scale studies that have evaluated the benefits of chemotherapy-based regimens in addressing <i>HER2</i>-altered advanced non-small-cell lung cancer (NSCLC) in a first-line setting. Data on <i>HER2</i> alteration subtypes and concomitant alterations are also limited. Accordingly, our retrospective, real-world POLISH study assesses the efficacy of first-line chemotherapy alone (C) as well as combinations with immune checkpoint inhibitors (C ...[more]

PMID: 35251321

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