Phase 1b trial of anti-HER2 antibody inetetamab and pan-HER inhibitor pyrotinib in HER2-positive advanced lung cancer

Yihua Huang1, Yuanyuan Zhao1, Yan Huang1, Yunpeng Yang1, Yaxiong Zhang1, Shaodong Hong1, Hongyun Zhao2, Shen Zhao1, Ting Zhou1, Gang Chen1, Huaqiang Zhou1, Yuxiang Ma2, Ningning Zhou1, Li Zhang1(), Wenfeng Fang1()

PDF
MedComm ›› 2024, Vol. 5 ›› Issue (5) : e536. DOI: 10.1002/mco2.536
ORIGINAL ARTICLE

Phase 1b trial of anti-HER2 antibody inetetamab and pan-HER inhibitor pyrotinib in HER2-positive advanced lung cancer

  • Yihua Huang1, Yuanyuan Zhao1, Yan Huang1, Yunpeng Yang1, Yaxiong Zhang1, Shaodong Hong1, Hongyun Zhao2, Shen Zhao1, Ting Zhou1, Gang Chen1, Huaqiang Zhou1, Yuxiang Ma2, Ningning Zhou1, Li Zhang1(), Wenfeng Fang1()
Author information +
History +

Abstract

There remains an unmet need for targeted therapies against advanced non-small-cell lung cancer (NSCLC) with HER2 mutations. To improve the antitumor activity of single anti-HER2 agent, this prospective, single-arm clinical trial (NCT05016544) examined the safety profile and efficacy of anti-HER2 antibody inetetamab and pan-HER TKI pyrotinib in HER2-posivite advanced NSCLC patients. Enrolled patients received inetetamab every 3 weeks and pyrotinib once per day (pyrotinib, dose-escalation part, 240 mg, 320 mg; dose-expansion part, 320 mg). Primary endpoints were dose-limiting toxicity (DLT) dosage and safety. Secondary endpoints included progression-free survival (PFS), objective response rate (ORR), and disease control rate (DCR). A total of 48 patients were enrolled. During the dose-escalation period, no DLT occurred. Diarrhea was the most commonly reported treatment-related adverse event (TRAE). Grade 3 TRAEs occurred in seven patients. The median PFS (mPFS) was 5.5 months [95% confidence interval (CI): 4.4–8.6 months]. The confirmed ORR and DCR reached 25% (11/44) and 84.1% (37/44), respectively. Responses were shown in patients with distinct HER2 aberrations. In summary, inetetamab in combination with pyrotinib demonstrated acceptable safety and antitumor activity among patients with advanced HER2-mutant NSCLC.

Keywords

HER2 mutations / inetetamab / non-small cell lung cancer / pyrotinib

Cite this article

Download citation ▾
Yihua Huang, Yuanyuan Zhao, Yan Huang, Yunpeng Yang, Yaxiong Zhang, Shaodong Hong, Hongyun Zhao, Shen Zhao, Ting Zhou, Gang Chen, Huaqiang Zhou, Yuxiang Ma, Ningning Zhou, Li Zhang, Wenfeng Fang. Phase 1b trial of anti-HER2 antibody inetetamab and pan-HER inhibitor pyrotinib in HER2-positive advanced lung cancer. MedComm, 2024, 5(5): e536 https://doi.org/10.1002/mco2.536

References

1 RL Siegel, AN Giaquinto, A Jemal. Cancer statistics, 2024. CA Cancer J Clin. 2024;74(1):12-49. doi:
2 AC Tan, DSW Tan. Targeted therapies for lung cancer patients with oncogenic driver molecular alterations. J Clin Oncol. 2022;40(6):611-625. doi:
3 SR Yang, AM Schultheis, H Yu, D Mandelker, M Ladanyi, R Buttner. Precision medicine in non-small cell lung cancer: current applications and future directions. Semin Cancer Biol. 2022;84: 184-198. doi:
4 H Shigematsu, T Takahashi, M Nomura, et al. Somatic mutations of the HER2 kinase domain in lung adenocarcinomas. Cancer Res. 2005;65(5):1642-1646. doi:
5 ME Arcila, JE Chaft, K Nafa, et al. Prevalence, clinicopathologic associations, and molecular spectrum of ERBB2 (HER2) tyrosine kinase mutations in lung adenocarcinomas. Clin Cancer Res. 2012;18(18):4910-4918. doi:
6 J Mazieres, S Peters, B Lepage, et al. Lung cancer that harbors an HER2 mutation: epidemiologic characteristics and therapeutic perspectives. J Clin Oncol. 2013;31(16):1997-2003. doi:
7 J Mazieres, F Barlesi, T Filleron, et al. Lung cancer patients with HER2 mutations treated with chemotherapy and HER2-targeted drugs: results from the European EUHER2 cohort. Ann Oncol. 2016;27(2):281-286. doi:
8 MG Kris, DR Camidge, G Giaccone, et al. Targeting HER2 aberrations as actionable drivers in lung cancers: phase II trial of the pan-HER tyrosine kinase inhibitor dacomitinib in patients with HER2-mutant or amplified tumors. Ann Oncol. 2015;26(7):1421-1427. doi:
9 R Dziadziuszko, EF Smit, U Dafni, et al. Afatinib in NSCLC with HER2 mutations: results of the prospective, open-label phase II NICHE trial of European Thoracic Oncology Platform (ETOP). J Thorac Oncol. 2019;14(6):1086-1094. doi:
10 Y Yu, Y Yang, H Li, Y Fan. Targeting HER2 alterations in non-small cell lung cancer: therapeutic breakthrough and challenges. Cancer Treat Rev. 2023;114:102520. doi:
11 YY Elamin, JP Robichaux, BW Carter, et al. Poziotinib for patients with HER2 exon 20 mutant non-small-cell lung cancer: results from a phase II trial. J Clin Oncol. 2022;40(7):702-709. doi:
12 X Le, R Cornelissen, M Garassino, et al. Poziotinib in non-small-cell lung cancer harboring HER2 exon 20 insertion mutations after prior therapies: ZENITH20-2 trial. J Clin Oncol. 2022;40(7):710-718. doi:
13 C Zhou, X Li, Q Wang, et al. Pyrotinib in HER2-mutant advanced lung adenocarcinoma after platinum-based chemotherapy: a multicenter, open-label, single-arm, phase II study. J Clin Oncol. 2020;38(24):2753-2761. doi:
14 Z Song, Y Li, S Chen, et al. Efficacy and safety of pyrotinib in advanced lung adenocarcinoma with HER2 mutations: a multicenter, single-arm, phase II trial. BMC Med. 2022;20(1):42. doi:
15 BT Li, R Shen, D Buonocore, et al. Ado-trastuzumab emtansine for patients with HER2-mutant lung cancers: results from a phase II basket trial. J Clin Oncol. 2018;36(24):2532-2537. doi:
16 BT Li, EF Smit, Y Goto, et al. Trastuzumab deruxtecan in HER2-mutant non-small-cell lung cancer. N Engl J Med. 2022;386(3):241-251. doi:
17 Z Shao, D Pang, H Yang, et al. Efficacy, safety, and tolerability of pertuzumab, trastuzumab, and docetaxel for patients with early or locally advanced ERBB2-positive breast cancer in Asia: the PEONY phase 3 randomized clinical trial. JAMA Oncol. 2020;6(3):e193692. doi:
18 J Wu, Z Jiang, Z Liu, et al. Neoadjuvant pyrotinib, trastuzumab, and docetaxel for HER2-positive breast cancer (PHEDRA): a double-blind, randomized phase 3 trial. BMC Med. 2022;20(1):498. doi:
19 J Cui, Y He, F Zhu, et al. Inetetamab, a novel anti-HER2 monoclonal antibody, exhibits potent synergistic anticancer effects with cisplatin by inducing pyroptosis in lung adenocarcinoma. Int J Biol Sci. 2023;19(13):4061-4081. doi:
20 T Wang, P Zhang, L Di, et al. Efficacy and safety of inetetamab in combination with chemotherapy as first-line treatment of HER2-positive metastatic breast cancer: a subgroup analysis in the HOPES study. Transl Breast Cancer Res. 2022;3: 15. doi:
21 L Bian, BH Xu, LJ Di, et al. [Phase III randomized controlled, multicenter, prospective study of recombinant anti-HER2 humanized monoclonal antibody (Cipterbin) combined with vinorelbine in patients with HER2 positive metastatic breast cancer: the HOPES study]. Zhonghua Yi Xue Za Zhi. 2020;100(30):2351-2357. doi:
22 L Deng, L Zhao, L Liu, H Huang. Systemic investigation of inetetamab in combination with small molecules to treat HER2-overexpressing breast and gastric cancers. Open Life Sci. 2023;18(1):20220535. doi:
23 N Jin, Y Xu, S Wang, et al. Inetetamab combined with pyrotinib and oral vinorelbine for patients with human epidermal growth factor receptor 2 positive advanced breast cancer: a single-arm phase 2 clinical trial. Cancer Pathog Ther. 2024;2(1):31-37. doi:
24 J Zhao, Y Cai, L Ding, et al. Abstract OT3-25-02: inetetamab combined with pyrotinib and chemotherapy in pretreated patients with HER2-positive metastatic breast cancer, a single arm, multicenter phase II clinical trial. Cancer Res. 2023;83(5):OT3-25-02. doi:
25 JD Hainsworth, F Meric-Bernstam, C Swanton, et al. Targeted therapy for advanced solid tumors on the basis of molecular profiles: results from MyPathway, an open-label, phase IIa multiple basket study. J Clin Oncol. 2018;36(6):536-542. doi:
26 JM van Berge Henegouwen, M Jebbink, LR Hoes, et al. Trastuzumab and pertuzumab combination therapy for advanced pre-treated HER2 exon 20-mutated non-small cell lung cancer. Eur J Cancer. 2022;171: 114-123. doi:
27 X Zhang, J Chen, Z Weng, et al. A new anti-HER2 antibody that enhances the anti-tumor efficacy of trastuzumab and pertuzumab with a distinct mechanism of action. Mol Immunol. 2020;119: 48-58. doi:
28 LC Tsao, J Force, ZC Hartman. Mechanisms of therapeutic antitumor monoclonal antibodies. Cancer Res. 2021;81(18):4641-4651. doi:
29 HY Chew, PO De Lima, JL Gonzalez Cruz, et al. Endocytosis inhibition in humans to improve responses to ADCC-mediating antibodies. Cell. 2020;180(5):895-914.e27. doi:
30 S Zhao, W Zhuang, B Han, et al. Phase 1b trial of anti-EGFR antibody JMT101 and osimertinib in EGFR exon 20 insertion-positive non-small-cell lung cancer. Nat Commun. 2023;14(1):3468. doi:
31 S Zhao, W Fang, H Pan, et al. Conformational landscapes of HER2 exon 20 insertions explain their sensitivity to kinase inhibitors in lung adenocarcinoma. J Thorac Oncol. 2020;15(6):962-972. doi:
32 H Hasegawa, H Yasuda, J Hamamoto, et al. Efficacy of afatinib or osimertinib plus cetuximab combination therapy for non-small-cell lung cancer with EGFR exon 20 insertion mutations. Lung Cancer. 2019;127: 146-152. doi:
33 B van Veggel, AJ de Langen, SMS Hashemi, et al. Afatinib and cetuximab in four patients with EGFR exon 20 insertion-positive advanced NSCLC. J Thorac Oncol. 2018;13(8):1222-1226. doi:
34 F Ma, Q Li, S Chen, et al. Phase I study and biomarker analysis of pyrotinib, a novel irreversible Pan-ErbB receptor tyrosine kinase inhibitor, in patients with human epidermal growth factor receptor 2-positive metastatic breast cancer. J Clin Oncol. 2017;35(27):3105-3112. doi:
PDF

Accesses

Citations

Detail

Sections
Recommended

/