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Pan-Cancer Landscape and Analysis of ERBB2 Mutations Identifies Poziotinib as a Clinically Active Inhibitor and Enhancer of T-DM1 Activity
Open accessAbstract
We characterized the landscape and drug sensitivity of ERBB2 (HER2) mutations in cancers. In 11 datasets (n = 211,726), ERBB2 mutational hotspots varied across 25 tumor types. Common HER2 mutants yielded differential sensitivities to eleven EGFR/HER2 tyrosine kinase inhibitors (TKIs) in vitro, and molecular dynamics simulations revealed that mutants with a reduced drug-binding pocket volume were associated with decreased affinity for larger TKIs. Overall, poziotinib was the most potent HER2 mutant-selective TKI tested. Phase II clinical testing in ERBB2 exon 20-mutant non-small cell lung cancer resulted in a confirmed objective response rate of 42% in the first 12 evaluable patients. In pre-clinical models, poziotinib upregulated HER2 cell-surface expression and potentiated the activity of T-DM1, resulting in complete tumor regression with combination treatment.
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“Clinically, second-generation TKIs have been associated with inhibition of wild-type EGFR and related adverse events15,35,36; however, most second-generation TKIs are dosed at the maximum tolerated doses, resulting in plasma concentrations 10–100 fold greater than concentrations necessary for inhibiting PACC mutations.”
From Structure-based classification predicts drug response in EGFR-mutant NSCLC (2021) · cites this paper as [36]
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Metadata
- Authors
- Robichaux, J. P., Elamin, Y. Y., Vijayan, R. S. K., Nilsson, M. B., Hu, L., He, J., Zhang, F., Pisegna, M., Poteete, A., Sun, H., Li, S., Chen, T., Han, H., Negrao, M. V., Ahnert, J. R., Diao, L., Wang, J., Le, X., Meric-Bernstam, F., Routbort, M., Roeck, B., Yang, Z., Raymond, V. M., Lanman, R. B., Frampton, G. M., Miller, V. A., Schrock, A. B., Albacker, L. A., Wong, K.-K., Cross, J. B., & Heymach, J. V.
- Affiliations
- The University of Texas MD Anderson Cancer Center (US)
- NYU Langone Health (US)
- Spectrum Pharmaceuticals (United States) (US)
- Guardant (United States) (US)
- Foundation Medicine (United States) (US)
- Corresponding author
- Heymach, John V.
- ORCID
- Robichaux, Jacqulyne P.
- Elamin, Yasir Y.
- Vijayan, R.S.K.
- Nilsson, Monique B.
- He, Junqin
- Zhang, Fahao
- Poteete, Alissa
- Sun, Huiying
- Li, Shuai
- Chen, Ting
- Han, Han
- Negrao, Marcelo Vailati
- Diao, Lixia
- Wang, Jing
- Le, Xiuning
- Raymond, Victoria M.
- Lanman, Richard B.
- Frampton, Garrett M.
- Miller, Vincent A.
- Schrock, Alexa B.
- Albacker, Lee A.
- Wong, Kwok-kin
- Cross, Jason B.
- Heymach, John V.
- Venue
- Cancer Cell
- Publisher
- Elsevier BV
- Published
- 2019-10
- Volume
- 36
- Issue
- 4
- Pages
- 444-457.e7
- ISSN
- 1535-6108 (ISSN-L)
- PMC
- PMC6944069
- OpenAlex
- W2977889895
- Cited by
- 242
- References
- 66
- Citations by year
- 2026: 21 · 2025: 34 · 2024: 33 · 2023: 40 · 2022: 43 · 2021: 43 · 2020: 28
- FWCI
- 12.00
- Type
- journal article
- Language
- en
- Update notices
- erratum (2020-03-16)
- Open access
- bronze
- doi.org
- Licence
- Locations
- Cancer Cell (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Cancer Institute
- Topics
- Health Sciences › Medicine › Oncology › HER2/EGFR in Cancer Research
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Treatments and Mutations
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer Genomics and Diagnostics
- Keywords
- ERBB2 mutations, HER2, poziotinib, tyrosine kinase inhibitors, trastuzumab emtansine, non-small cell lung cancer, drug sensitivity, molecular dynamics simulation, drug-binding pocket, combination therapy
- MeSH terms
- Antineoplastic Agents, Immunological, Progression-Free Survival, Ado-Trastuzumab Emtansine, Adult, Animals, Antineoplastic Combined Chemotherapy Protocols, Disease Models, Animal, DNA Mutational Analysis, Drug Synergism, Female, Humans, Male, Mice, Transgenic, Mutation, Neoplasms, Quinazolines, Erb-b2 Receptor Tyrosine Kinases, Drug Resistance, Neoplasm, Protein Kinase Inhibitors, Mice, Datasets as Topic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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