Supplementing capecitabine with neratinib instead of lapatinib is associated with a significant improvement in the progression-free survival of previously treated patients with metastatic HER2-positive breast cancer, shows the phase 3 NALA trial.

After 2 years of treatment, 94.2% of the patients using neratinib were alive and free from recurrence versus 91.9% of controls.

Promising agents under investigation are drugs targeting the HER2 pathways such as tucatinib, neratinib, pyrotinib, trastuzumab deruxtecan.

Neratinib shows promise for EGFR exon 18-mutated NSCLC   Valentina Boni (START Madrid-CIOCC, Spain) outlined the initial results of 10 patients with EGFR exon 18 mutations included in the phase 2 SUMMIT basket trial of the pan-HER–TKI neratinib, which has been shown to be active against these mutations in preclinical studies and an earlier phase 2 study.

“Alternatives for this patient population include neratinib, tucatinib, and trastuzumab deruxtecan, which have emerged as active regimens, albeit with different levels of effectiveness, and all with notable toxic effects.”

During a median 14.4 months of follow-up, 25% of 20 patients with HER2 mutations treated with oral neratinib 240 mg with or without standard-dose fulvestrant had an objective response, with a median response duration of 5.7 months and a median progression-free survival (PFS) of 5.4 months.

But he added that “its value in the setting of pertuzumab, T-DM1, tucatinib, DS-8201 and neratinib is less clear,” and “the toxicity profile needs attention.” medwireNews is an independent medical news service provided by Springer Healthcare. © 2020 Springer Healthcare part of the Springer Nature Group 2020 ASCO Annual Meeting; 29–31 May