Thoracic Cancer (Jan 2023)

Chinese expert consensus on the diagnosis and treatment of HER2‐altered non–small cell lung cancer

  • Shirong Zhang,
  • Wenxian Wang,
  • Chunwei Xu,
  • Yongchang Zhang,
  • Xiuyu Cai,
  • Qian Wang,
  • Zhengbo Song,
  • Ziming Li,
  • Jinpu Yu,
  • Wenzhao Zhong,
  • Zhijie Wang,
  • Jingjing Liu,
  • Anwen Liu,
  • Wen Li,
  • Ping Zhan,
  • Hongbing Liu,
  • Tangfeng Lv,
  • Liyun Miao,
  • Lingfeng Min,
  • Gen Lin,
  • Long Huang,
  • Jingping Yuan,
  • Zhansheng Jiang,
  • Xingxiang Pu,
  • Chuangzhou Rao,
  • Dongqing Lv,
  • Zongyang Yu,
  • Xiaoyan Li,
  • Chuanhao Tang,
  • Chengzhi Zhou,
  • Junping Zhang,
  • Hui Guo,
  • Qian Chu,
  • Rui Meng,
  • Xuewen Liu,
  • Jingxun Wu,
  • Jin Zhou,
  • Zhengfei Zhu,
  • Weiwei Pan,
  • Xiaowei Dong,
  • Fei Pang,
  • Kai Wang,
  • Chao Yao,
  • Guomin Lin,
  • Site Li,
  • Zhi Yang,
  • Jiancheng Luo,
  • Hongtao Jia,
  • Xiuqing Nie,
  • Liping Wang,
  • Youcai Zhu,
  • Xiao Hu,
  • Yanru Xie,
  • Xinqing Lin,
  • Jing Cai,
  • Yang Xia,
  • Huijing Feng,
  • Lin Wang,
  • Yingying Du,
  • Wang Yao,
  • Xuefei Shi,
  • Xiaomin Niu,
  • Dongmei Yuan,
  • Yanwen Yao,
  • Jing Kang,
  • Jiatao Zhang,
  • Chao Zhang,
  • Wenbin Gao,
  • Jianhui Huang,
  • Yinbin Zhang,
  • Pingli Sun,
  • Hong Wang,
  • Mingxiang Ye,
  • Dong Wang,
  • Zhaofeng Wang,
  • Bing Wan,
  • Donglai Lv,
  • Genhua Yu,
  • Lin Shi,
  • Yuanli Xia,
  • Feng Gao,
  • Xiaochen Zhang,
  • Tao Xu,
  • Wei Zhou,
  • Haixia Wang,
  • Zhefeng Liu,
  • Nong Yang,
  • Lin Wu,
  • Qiming Wang,
  • Guansong Wang,
  • Zhuan Hong,
  • Jiandong Wang,
  • Meiyu Fang,
  • Yong Fang,
  • Yiping Zhang,
  • Yong Song,
  • Shenglin Ma,
  • Wenfeng Fang,
  • Yuanzhi Lu

DOI
https://doi.org/10.1111/1759-7714.14743
Journal volume & issue
Vol. 14, no. 1
pp. 91 – 104

Abstract

Read online

Abstract Human epidermal growth factor receptor 2 (HER2) possesses tyrosine kinase activity and participates in cell growth, differentiation and migration, and survival. Its alterations, mainly including mutations, amplifications, and overexpression are associated with poor prognosis and are one of the major drivers in non–small cell lung cancer (NSCLC). Several clinical trials had been investigating on the treatments of HER2‐altered NSCLC, including conventional chemotherapy, programmed death 1 (PD‐1) inhibitors, tyrosine kinase inhibitors (TKIs) and antibody‐drug conjugates (ADCs), however, the results were either disappointing or encouraging, but inconsistent. Trastuzumab deruxtecan (T‐DXd) was recently approved by the Food and Drug Administration as the first targeted agent for treating HER2‐mutant NSCLC. Effective screening of patients is the key to the clinical application of HER2‐targeted agents such as TKIs and ADCs. Various testing methods are nowadays available, including polymerase chain reaction (PCR), next‐generation sequencing (NGS), fluorescence in situ hybridization (FISH), immunohistochemistry (IHC), etc. Each method has its pros and cons and should be reasonably assigned to appropriate patients for diagnosis and guiding treatment decisions. To help standardize the clinical workflow, our expert group reached a consensus on the clinical management of HER2‐altered NSCLC, focusing on the diagnosis and treatment strategies.

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