Treatment Patterns and Efficacy/Safety of the Drugs in HER2+ NSCLC: A Systemic Literature Review
Author(s)
Jean Lee, PharmD;
University of Washington, The Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, Seattle, WA, USA
University of Washington, The Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, Seattle, WA, USA
Presentation Documents
OBJECTIVES: As the lung cancer is the second most common cancer in the U.S. and non-small cell lung cancer (NSCLC) consists of 85% of overall lung cancer cases, this study aimed to evaluate the prior treatment patterns, including specific drug classes, and to assess the efficacy and safety of drugs used for HER2-positive (HER2+) NSCLC in patients who have received at least one prior anticancer therapy.
METHODS: A systematic literature review was conducted using PubMed from January 2014 to August 2024. Phase II clinical studies were selected based on the inclusion of HER2+ NSCLC patients who had progressed after prior treatment. Outcomes of interest included Objective Response Rate (ORR), Disease Control Rate (DCR), median Duration of Response (mDOR), median Overall Survival (mOS), and median Progression-Free Survival (mPFS). Adverse events were also reviewed across different drug classes, including antibody-drug conjugates (ADC), tyrosine kinase inhibitors (TKI), and combination therapies.
RESULTS: Nineteen studies were included, involving sample sizes ranging from 13 to 105 participants and treatment durations between 2.7 and 8.3 months. ADC treatments exhibited the highest DCR, while TKI treatments demonstrated the highest ORR. Median survival outcomes (mOS, mDOR, mPFS) were comparable across all drug classes, differing by approximately one month. Adverse events were predominantly gastrointestinal, with TKIs also causing paronychia and rash. Most patients (96.6%) had chemotherapy as the prior treatment, followed by immune checkpoint inhibitors.
CONCLUSIONS: These studies highlight the varying efficacy and safety profiles of ADCs, TKIs, and combination therapies in HER2+ NSCLC patients; however, it is challenging to draw definitive conclusions when pooling diverse patient groups. While all drug classes showed promising survival benefits, the differences in ORR and DCR suggest potential tailored treatment strategies. Further research is needed to determine whether a standardized approach or an individualized treatment strategy is optimal for HER2+ NSCLC patients progressing on multiple lines of therapy.
METHODS: A systematic literature review was conducted using PubMed from January 2014 to August 2024. Phase II clinical studies were selected based on the inclusion of HER2+ NSCLC patients who had progressed after prior treatment. Outcomes of interest included Objective Response Rate (ORR), Disease Control Rate (DCR), median Duration of Response (mDOR), median Overall Survival (mOS), and median Progression-Free Survival (mPFS). Adverse events were also reviewed across different drug classes, including antibody-drug conjugates (ADC), tyrosine kinase inhibitors (TKI), and combination therapies.
RESULTS: Nineteen studies were included, involving sample sizes ranging from 13 to 105 participants and treatment durations between 2.7 and 8.3 months. ADC treatments exhibited the highest DCR, while TKI treatments demonstrated the highest ORR. Median survival outcomes (mOS, mDOR, mPFS) were comparable across all drug classes, differing by approximately one month. Adverse events were predominantly gastrointestinal, with TKIs also causing paronychia and rash. Most patients (96.6%) had chemotherapy as the prior treatment, followed by immune checkpoint inhibitors.
CONCLUSIONS: These studies highlight the varying efficacy and safety profiles of ADCs, TKIs, and combination therapies in HER2+ NSCLC patients; however, it is challenging to draw definitive conclusions when pooling diverse patient groups. While all drug classes showed promising survival benefits, the differences in ORR and DCR suggest potential tailored treatment strategies. Further research is needed to determine whether a standardized approach or an individualized treatment strategy is optimal for HER2+ NSCLC patients progressing on multiple lines of therapy.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE361
Topic
Economic Evaluation
Disease
SDC: Oncology