Lung Cancer

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Fam-trastuzumab deruxtecan-nxki (Enhertu) could provide patients with metastatic non–small cell lung cancer (NSCLC) who harbor HER2 exon 20 insertion mutations and high HER2 expression a more specific and less toxic treatment compared with platinum doublet chemotherapy. However, the jury is still out on whether the agent will be pursued as an alternative frontline therapy and in both patient subsets.

The FDA has approved pembrolizumab (Keytruda) to treat adult and pediatric patients with unresectable or metastatic solid tumors that are tissue tumor mutational burden–high (≥10 mutations/megabase) and have progressed following prior therapy and who have no satisfactory alternative treatment options.

With minimally invasive procedures to test lung cancer tumors, there often isn't enough tissue to undergo a full biomarker test, pointing toward the strength of liquid biopsies, explained Lynette M. Sholl, MD, chief of thoracic pathology at Brigham and Women's Hospital, Dana-Farber Cancer Institute, and associate professor at Harvard Medical School.