Activity of the Hsp90 inhibitor luminespib among non-small-cell lung cancers harboring EGFR exon 20 insertions
Open accessAbstract
Background: There are currently no approved targeted therapies for non-small-cell lung cancer (NSCLC) patients with EGFR exon 20 insertions (ins20), a subgroup of EGFR mutations that are generally refractory to first/second generation EGFR inhibitors. We report the final results of a phase II trial evaluating the activity of the Hsp90 inhibitor luminespib (AUY922) in NSCLC patients with EGFR ins20. Patients and methods: Twenty-nine patients with stage IV NSCLC with EGFR ins20 identified on local testing and at least one prior therapy were enrolled on the trial between August 2013 and October 2016. The primary end point was objective response rate (ORR), with a pre-determined target rate of effectiveness [defined as the rate of partial response (PR) plus stable disease (SD) lasting ≥3 months] of 20%. Secondary end points were PFS, overall survival (OS), safety and response by EGFR ins20 subtype. Results: Among the 29 patients (18 females, median age 60 years) the ORR was 17%, median progression-free survival was 2.9 months (95% CI 1.4-5.6) and median OS (mOS) was 13 months (95% CI 4.9-19.5). The results exceeded the pre-determined target rate of effectiveness with 11/29 (38%) patients having a PR or an SD ≥3 months. The most common luminespib-related toxicities were diarrhea (83%), visual changes (76%) and fatigue (45%). All study treatment was stopped on 28 February 2017 due to dissolution of study drug availability; 3 patients were on treatment at study termination. Conclusion: The study met its primary end point, suggesting that luminespib may be an active therapy for advanced NSCLC patients with EGFR ins20. Luminespib is generally well-tolerated, though reversible low-grade ocular toxicity is common. Further study of luminespib and other hsp90 inhibitors in this population is warranted. Study registration (ClinicalTrials.gov): NCT01854034.
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A phase II study of luminespib in EGFR exon 20 insertions reported a 17% ORR, a 38% DCR, and a 2.8 month median PFS.
“A phase II study in EGFR exon 20 insertions reported a modest activity in this molecularly defined subgroup, with a 17% ORR, a 38% DCR, and a 2.8 month median PFS [81].”
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EGFR exon 20 insertion in non-small cell lung cancer
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HIFs: The central drivers of tumors and their role as molecular switches in targeted therapy?
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- Authors
- Piotrowska, Z., Costa, D. B., Oxnard, G. R., Huberman, M., Gainor, J. F., Lennes, I. T., Muzikansky, A., Shaw, A. T., Azzoli, C. G., Heist, R. S., & Sequist, L. V.
- Affiliations
- Massachusetts General Hospital (US)
- Beth Israel Deaconess Medical Center (US)
- Harvard University (US)
- Corresponding author
- Piotrowska, Z.
- ORCID
- Venue
- Annals of Oncology
- Publisher
- Elsevier BV
- Published
- 2018-10
- Volume
- 29
- Issue
- 10
- Pages
- 2092-2097
- ISSN
- 0923-7534 (ISSN-L)
- OpenAlex
- W2898413605
- Cited by
- 79
- References
- 22
- Citations by year
- 2026: 3 · 2025: 11 · 2024: 10 · 2023: 10 · 2022: 10 · 2021: 15 · 2020: 13 · 2019: 6 · 2018: 1
- FWCI
- 6.66
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Annals of Oncology (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- Novartis Pharmaceuticals Corporation
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Treatments and Mutations
- Health Sciences › Medicine › Oncology › Lung Cancer Research Studies
- Health Sciences › Medicine › Oncology › HER2/EGFR in Cancer Research
- Keywords
- AUY922, Hsp90 inhibitors, EGFR exon 20 insertion, non-small cell lung cancer, EGFR mutation, targeted therapy, objective response rate, progression-free survival, ocular toxicity, diarrhea
- MeSH terms
- Adenocarcinoma, Adult, Aged, Carcinoma, Non-Small-Cell Lung, Carcinoma, Squamous Cell, Exons, Female, Follow-Up Studies, Humans, Isoxazoles, Lung Neoplasms, Male, Middle Aged, Prognosis, Resorcinols, Biomarkers, Tumor, Cohort Studies, Survival Rate, Mutagenesis, Insertional, HSP90 Heat-Shock Proteins, ErbB Receptors
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