A retrospective study of first‐line therapy and subsequent pyrotinib treatment in advanced lung adenocarcinoma with HER2 mutations

Abstract Objectives HER2 is an infrequently mutated driver gene in non‐small cell lung cancer (NSCLC). At present, there has been no comprehensive large‐scale clinical study to establish the optimal first‐line treatment strategy for advanced lung adenocarcinoma (LUAD) with HER2‐Mutant. Besides that, the effectiveness and safety of pyrotinib, a pan‐HER inhibitor, in the context of NSCLC are still undergoing investigation. Materials and Methods In this study, we conducted a retrospective data collection of HER2‐Mutated advanced LUAD who received first‐line treatment and pyrotinib between May 2014 and June 2023. Patients treated with chemotherapy, chemotherapy + immune checkpoint inhibitors (ICIs), chemotherapy + bevacizumab and pyrotinib in first‐line treatment. Furthermore, we collected data on the efficacy and safety of pyrotinib in these patients after disease progression. The main endpoint of the study was progression‐free survival (PFS). Results In the final analysis, 89 patients were included in the first‐line cohort and 30 patients were included in the pyrotinib cohort. In the first‐line treatment cohort, chemotherapy + ICIs, chemotherapy + bevacizumab, and pyrotinib exhibited notable survival benefits compared to chemotherapy (median PFS: 9.87 vs. 7.77 vs. 7.10 vs. 5.40 months, p‐value