First-Line Pyrotinib Combination Therapy for HER2-Mutated Advanced NSCLC: A Retrospective Cohort Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patient Selection
2.2. Method
2.3. Response Assessment
2.4. Statistical Analysis
3. Results
3.1. Clinical Characteristics
3.2. Molecular Characteristics
3.3. Efficacy Analysis
3.4. Subgroup Analysis
3.5. Safety
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
References
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Characteristics | All Patients | Pyrotinib Plus Chemotherapy |
---|---|---|
Total | 144 | 21 (43.8%) |
Gender | ||
Female | 87 (60.4%) | 15 (71.4%) |
Male | 57 (39.6%) | 6 (28.6%) |
Age | 62.0 ± 10.0 | 66.3 ± 9.4 |
Smoking history | ||
No | 106 (73.6%) | 12 (57.1%) |
Yes | 38 (26.4%) | 9 (42.9%) |
Physiology | ||
Adenocarcinoma | 140 (97.2%) | 21 (100.0%) |
Squamous cell carcinoma | 3 (2.1%) | 0 (0.0%) |
Adenosquamous carcinoma | 1 (0.7%) | 0 (0.0%) |
TNM Stage | ||
I–II | 34 (23.6%) | 0 (0.0%) |
III–IV | 110 (76.4%) | 21 (100.0%) |
ECOG score | ||
0–1 | 95 (81.9%) | 17 (81.0%) |
≥2 | 21 (18.1%) | 4 (19.0%) |
Brain metastasis | ||
No | 120 (83.3%) | 14 (66.7%) |
Yes | 24 (16.7%) | 7 (33.3%) |
HER2 exon20 Insertion Subtypes | Number | Proportion |
---|---|---|
p.A775_G776insYVMA | 69 | 47.90% |
p. G776delinsVC | 10 | 6.90% |
p.P780_Y781insGSP | 7 | 4.90% |
p. G776delinsLC | 3 | 2.10% |
p. G776delinsVV | 2 | 1.40% |
p.G778_S779insCPG | 2 | 1.40% |
p.G776_V777delinsCVC | 1 | 0.70% |
p.G776_V777delinsAVCG | 1 | 0.70% |
p.V777_G778insCG | 1 | 0.70% |
p.M774delinsVWL | 1 | 0.70% |
Total | 97 | 67.4% |
Case | Gender/ Age | Brain Metastases | HER2 Mutation Subtype | Co-Current Genes | First-Line Treatment | Efficacy | PFS/Months | OS/Months |
---|---|---|---|---|---|---|---|---|
1 | M/76 | Yes | Exon20 p.A775_G776insYVMA | / | Pyrotinib/Pemetrexed/Carboplatin | SD | 5.03 | 6.83 |
2 | M/82 | No | Exon8 p.S310F | / | Pyrotinib/Pemetrexed/Carboplatin | PR | 14.50 | 50.73+ |
3 | M/74 | No | Exon20 p.A775_G776insYVMA | / | Pyrotinib/Pemetrexed/Carboplatin | SD | 17.17 | 27.87+ |
4 | F/83 | No | Exon20 p.A775_G776insYVMA | / | Pyrotinib/Pemetrexed/Carboplatin | SD | 3.90 | 15.93 |
5 | F/73 | No | Exon20 p.A775_G776insYVMA | TP53 | Pyrotinib/Pemetrexed/Carboplatin | SD | 10.57 | 20.30 |
6 | F/65 | Yes | Exon20 p.A775_G776insYVMA | / | Pyrotinib/Nab-paclitaxel/Carboplatin | SD | 10.87 | 26.27+ |
7 | F/67 | Yes | Exon20 p.A775_G776insYVMA | / | Pyrotinib/Pemetrexed/Carboplatin | PR | 5.10 | 6.23 |
8 | M/56 | No | Exon 20 p.S783A | / | Pyrotinib/Pemetrexed/Carboplatin | SD | 13.73 | 18.77 |
9 | M/60 | Yes | Exon20 p.A775_G776insYVMA | / | Pyrotinib/Pemetrexed/Carboplatin | PR | 7.00 | 13.03 |
10 | F/67 | No | Exon20 p.G776delinsVC | / | Pyrotinib/Pemetrexed/Carboplatin | SD | 11.27 | 26.53 |
11 | F/67 | No | Exon20 p.A775_G776insYVMA | TP53 | Pyrotinib/Pemetrexed/Carboplatin | SD | 12.80 | 75.10+ |
12 | F/67 | No | Exon20 p.A775_G776insYVMA | TP53 | Pyrotinib/Pemetrexed/Carboplatin | SD | 8.60 | 22.30 |
13 | F/47 | No | Exon20 p.A775_G776insYVMA | / | Pyrotinib/Pemetrexed/Carboplatin/Bevacizumab | SD | 18.60 | 18.67+ |
14 | F/64 | No | Exon20 p.G778_S779insCPG | MDM2 | Pyrotinib/Pemetrexed/Carboplatin/Bevacizumab | PR | 17.73 | 48.60+ |
15 | F/63 | Yes | Exon20 p.A775_G776insYVMA | TP53 | Pyrotinib/Pemetrexed/Carboplatin/Bevacizumab | PR | 11.53 | 20.13 |
16 | F/59 | Yes | Exon19 p.L755S | / | Pyrotinib/Pemetrexed/Carboplatin/Bevacizumab | PD | 1.77 | 9.27 |
17 | F/58 | No | Exon20 p.A775_G776insYVMA | / | Pyrotinib/Paclitaxel liposome/ Carboplatin/Bevacizumab | SD | 11.03 | 20.97 |
18 | F/50 | No | Exon19 p.L755A | / | Pyrotinib/Pemetrexed/Carboplatin/Bevacizumab | PR | 12.33+ | 12.33+ |
19 | F/76 | Yes | Exon20 p.A775_G776insYVMA | / | Pyrotinib/Pemetrexed/Carboplatin/Bevacizumab | SD | 4.40 | 6.93 |
20 | F/71 | No | Exon17 p.I655V | / | Pyrotinib/Pemetrexed/Carboplatin/Bevacizumab | SD | 12.93 | 29.53+ |
21 | M/67 | No | Exon20 p.A775_G776insYVMA | / | Pyrotinib/Pemetrexed/Carboplatin | PR | 15.73 | 26.27+ |
Adverse Events | Any Grade | Grade 1–2 (%) | Grade 3 (%) |
---|---|---|---|
Any events | 19 (90.5%) | ||
Diarrhea | 18 (85.7%) | 16 (76.2%) | 2 (9.5%) |
Myelosuppression | 11 (52.4%) | 10 (47.6%) | 1 (4.8%) |
Nausea | 10 (47.6%) | 10 (47.6%) | 0 (0.0%) |
Fatigue | 9 (42.9%) | 9 (42.9%) | 0 (0.0%) |
Decreased appetite | 7 (33.3%) | 7 (33.3%) | 0 (0.0%) |
Elevated transaminase | 6 (28.6%) | 6 (28.6%) | 0 (0.0%) |
Electrolyte imbalance | 3 (14.3%) | 3 (14.3%) | 0 (0.0%) |
Hand-foot syndrome | 2 (9.5%) | 2 (9.5%) | 0 (0.0%) |
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Xiang, Y.; Zhang, M.; Wang, Q.; Liu, J.; Zeng, L.; Sun, A.; Lu, K. First-Line Pyrotinib Combination Therapy for HER2-Mutated Advanced NSCLC: A Retrospective Cohort Analysis. Curr. Oncol. 2025, 32, 148. https://doi.org/10.3390/curroncol32030148
Xiang Y, Zhang M, Wang Q, Liu J, Zeng L, Sun A, Lu K. First-Line Pyrotinib Combination Therapy for HER2-Mutated Advanced NSCLC: A Retrospective Cohort Analysis. Current Oncology. 2025; 32(3):148. https://doi.org/10.3390/curroncol32030148
Chicago/Turabian StyleXiang, Yan, Meiling Zhang, Qian Wang, Jingwen Liu, Lulin Zeng, Ao Sun, and Kaihua Lu. 2025. "First-Line Pyrotinib Combination Therapy for HER2-Mutated Advanced NSCLC: A Retrospective Cohort Analysis" Current Oncology 32, no. 3: 148. https://doi.org/10.3390/curroncol32030148
APA StyleXiang, Y., Zhang, M., Wang, Q., Liu, J., Zeng, L., Sun, A., & Lu, K. (2025). First-Line Pyrotinib Combination Therapy for HER2-Mutated Advanced NSCLC: A Retrospective Cohort Analysis. Current Oncology, 32(3), 148. https://doi.org/10.3390/curroncol32030148