Introducing the Landscape of HER2-Mutant Non-Small Cell Lung Cancer

The faculty open by describing HER2-mutant non-small cell lung cancer (NSCLC) as ‘the poor sibling of EGFR-mutant disease’, a comparison one of the panelists derived from an editorial. They note that HER2-mutated lung cancer occurs mainly in nonsmokers and is somewhat less common. In recent years an antibody-drug conjugate (ADC), trastuzumab deruxtecan, and now 2 tyrosine kinase inhibitors (TKIs), zongertinib and sevabertinib, have arrived, and the faculty plan to discuss how to use and sequence them. The conversation then turns to biomarker testing. The faculty stress that every patient with advanced NSCLC, especially adenocarcinoma, needs comprehensive next-generation sequencing, preferably covering both DNA and RNA. They describe sending tissue testing and liquid biopsy together because the 2 complement each other. Tissue is still more sensitive, but an occasional patient is negative in tissue and positive in blood.