Info
🌱 來自: NSCLC
Targeted therapy-of-NSCLC
- For this section, approved tx are in bold. Other agents w/ activity listed. All tx apply to stage IV CAs except adj. Osimertinib
- EGFR-as-Targeted therapy-of-NSCLC
- see EGFR Mt
- EGFR TKI-as-Targeted therapy-of-NSCLC On-target resistance and Off-target resistance
- ERBB2/HER2 mt: Trastuzumab deruxtecan-nxki (T-DXd, ORR 55%, PFS 8.2 mos), trasuzumab emtansine (T-DM1, ORR 44%) (JCO 2018;36:2532)
- KRAS G12C mt: 2L+ sotorasib (ORR 37%, PFS 6.8 mos), adagrasib
- MET exon 14 alteration: Capmatinib (ORR 68% tx naïve, ORR 41% pretx) (NEJM 2020;383:944) or tepotinib (ORR 46%, PFS 8.5 mos); crizotinib. S/e: Peripheral edema
- MET high amp (GCN ≥10 or MET/CEP7 ≥4): Capmatinib (ORR 40% tx naïve, ORR 29% pre-treated.) (NEJM 2020;383:944), crizotinib (ORR 38%)
- BRAF V600E: Dabrafenib + trametinib (ORR 64%, PFS 10.9 mos) (Lancet Onc 2017;18:1307)
- ALK fusion:
- ROS1 fusion:
- Initial tx: Entrectinib (ORR 77%, PFS 19.0 mos) (JCO 2021;39:1253), crizotinib, or ceritinib. Tox: Fluid retention, visual Δs
- Subsequent tx: Lorlatinib
- RET fusion: Selpercatinib (ORR 85% tx naïve, ORR 64% pretx) (NEJM 2020;383:813) or pralsetinib (ORR 79% tx naïve, ORR 62% pretx)
- NTRK1/2/3 fusion: Larotrectinib (ORR 73%, PFS 35.0 mo) or entrectinib (ORR 69%, PFS 15.0 mos)