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|Ref Type||Journal Article|
|Authors||Oaknin A, Friedman CF, Roman LD, D'Souza A, Brana I, Clement-Bidard F, Goldman J, Alvarez EA, Boni V, ElNaggar AC, Passalacqua R, Do KTM, Santin AD, Keyvanjah K, Xu F, Eli LD, Lalani AS, Bryce RP, Hyman DM, Meric-Bernstam F, Solit DB, Monk BJ|
|Title||Neratinib in patients with HER2-mutant, metastatic cervical cancer: Findings from the phase 2 SUMMIT basket trial.|
|Date||2020 Jul 25|
|Abstract Text||Somatic HER2 mutations occur in ~5% of cervical cancers and are considered oncogenic and associated with poor prognosis. Neratinib, an irreversible pan-HER tyrosine kinase inhibitor, is active in multiple HER2-mutant cancers. SUMMIT is a phase II basket trial investigating the efficacy and safety of neratinib in solid tumors.Patients with HER2-mutant, persistent, metastatic/recurrent cervical cancer with disease progression after platinum-based treatment for advanced/recurrent disease received oral neratinib 240 mg/day with mandatory loperamide prophylaxis during cycle 1. The primary endpoint was confirmed objective response rate (ORR). Secondary endpoints included: response duration (DOR); clinical benefit rate (CBR); progression-free survival (PFS); overall survival (OS); safety.Sixteen eligible patients were enrolled; 10 (62.5%) had endocervical adenocarcinoma. The most common HER2 mutation was S310F (63% of patients). Three of 12 RECIST-measurable patients had confirmed partial responses (ORR 25%; 95%CI 5.5-57.2%); 3 had stable disease ≥16 weeks (CBR 50%; 95%CI 21.1-78.9%). DOR for responders were 5.6, 5.9, and 12.3 months. Median PFS was 7.0 months (95%CI 0.7-18.3 months); median OS was 16.8 months (95%CI 4.1-NE months). Diarrhea (75%), nausea (44%), and decreased appetite (38%) were the most common adverse events. One patient (6%) reported grade 3 diarrhea. There were no grade 4 events, and no diarrhea-related treatment discontinuations.Neratinib monotherapy showed evidence of activity in heavily pretreated patients with HER2-mutant cervical cancer, with no new safety signals. Given the few effective options for cervical cancer after platinum-based therapy failure, neratinib warrants further investigation in this molecularly defined patient population.NCT01953926 (ClinicalTrials.gov), 2013-002872-42 (EudraCT).|
|Molecular Profile||Treatment Approach|
|Gene Name||Source||Synonyms||Protein Domains||Gene Description||Gene Role|
|Therapy Name||Drugs||Efficacy Evidence||Clinical Trials|
|Drug Name||Trade Name||Synonyms||Drug Classes||Drug Description|
|Gene||Variant||Impact||Protein Effect||Variant Description||Associated with drug Resistance|
|Molecular Profile||Indication/Tumor Type||Response Type||Therapy Name||Approval Status||Evidence Type||Efficacy Evidence||References|
|ERBB2 S310F ERBB2 V842I||cervical cancer||predicted - sensitive||Neratinib||Case Reports/Case Series||Actionable||In a Phase II trial (SUMMIT), a heavily pretreated cervical cancer patient co-harboring ERBB2 (HER2) S310F and ERBB2 (HER2) V842I demonstrated a partial response when treated with Nerlynx (neratinib) (PMID: 32723675; NCT01953926).||32723675|
|ERBB2 R678Q||cervical cancer||predicted - sensitive||Neratinib||Case Reports/Case Series||Actionable||In a Phase II trial (SUMMIT), a heavily pretreated cervical cancer patient harboring ERBB2 (HER2) R678Q demonstrated stable disease when treated with Nerlynx (neratinib) (PMID: 32723675; NCT01953926).||32723675|
|ERBB2 act mut||cervical cancer||predicted - sensitive||Neratinib||Phase II||Actionable||In a Phase II trial (SUMMIT), heavily pretreated cervical cancer patients harboring an ERBB2 (HER2) mutation demonstrated an objective response rate of 25% (4/16), including 1 complete response and 3 partial responses, a median progression-free survival of 7.0 months, a median overall survival of 16.8 months, and a clinical benefit rate of 43.8% (7/16) when treated with Nerlynx (neratinib) (PMID: 32723675; NCT01953926).||32723675|
|ERBB2 G776V||cervical cancer||predicted - sensitive||Neratinib||Case Reports/Case Series||Actionable||In a Phase II trial (SUMMIT), a heavily pretreated cervical cancer patient harboring ERBB2 (HER2) G776V demonstrated stable disease when treated with Nerlynx (neratinib) (PMID: 32723675; NCT01953926).||32723675|