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HER2-Mediated Internalization of Cytotoxic Agents in ERBB2 Amplified or Mutant Lung Cancers

Open access
Li, Bob T., Michelini, Flavia, Misale, Sandra, Cocco, Emiliano, Baldino, Laura, Cai, Yanyan, Shifman, Sophie, Tu, Hai-Yan, Myers, Mackenzie L., Xu, Chongrui, Mattar, Marissa, Khodos, Inna, Little, Megan, Qeriqi, Besnik, Weitsman, Gregory, Wilhem, Clare J., Lalani, Alshad S., Diala, Irmina, Freedman, Rachel A., Lin, Nancy U., Solit, David B., Berger, Michael F., Barber, Paul R., Ng, Tony, Offin, Michael, Isbell, James M., Jones, David R., Yu, Helena A., Thyparambil, Sheeno, Liao, Wei-Li, Bhalkikar, Anuja, Cecchi, Fabiola, Hyman, David M., Lewis, Jason S., Buonocore, Darren J., Ho, Alan L., Makker, Vicky, Reis-Filho, Jorge S., Razavi, Pedram, Arcila, Maria E., Kris, Mark G., Poirier, John T., Shen, Ronglai, Tsurutani, Junji, Ulaner, Gary A., de Stanchina, Elisa, Rosen, Neal, Rudin, Charles M., Scaltriti, Maurizio·2020·Cancer Discovery

Abstract

Amplification of and oncogenic mutations in ERBB2, the gene encoding the HER2 receptor tyrosine kinase, promote receptor hyperactivation and tumor growth. Here we demonstrate that HER2 ubiquitination and internalization, rather than its overexpression, are key mechanisms underlying endocytosis and consequent efficacy of the anti-HER2 antibody–drug conjugates (ADC) ado-trastuzumab emtansine (T-DM1) and trastuzumab deruxtecan (T-DXd) in lung cancer cell lines and patient-derived xenograft models. These data translated into a 51% response rate in a clinical trial of T-DM1 in 49 patients with ERBB2-amplified or -mutant lung cancers. We show that cotreatment with irreversible pan-HER inhibitors enhances receptor ubiquitination and consequent ADC internalization and efficacy. We also demonstrate that ADC switching to T-DXd, which harbors a different cytotoxic payload, achieves durable responses in a patient with lung cancer and corresponding xenograft model developing resistance to T-DM1. Our findings may help guide future clinical trials and expand the field of ADC as cancer therapy. Significance: T-DM1 is clinically effective in lung cancers with amplification of or mutations in ERBB2. This activity is enhanced by cotreatment with irreversible pan-HER inhibitors, or ADC switching to T-DXd. These results may help address unmet needs of patients with HER2-activated tumors and no approved targeted therapy. See related commentary by Rolfo and Russo, p. 643. This article is highlighted in the In This Issue feature, p. 627

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Metadata

Authors
Li, B. T., Michelini, F., Misale, S., Cocco, E., Baldino, L., Cai, Y., Shifman, S., Tu, H.-Y., Myers, M. L., Xu, C., Mattar, M., Khodos, I., Little, M., Qeriqi, B., Weitsman, G., Wilhem, C. J., Lalani, A. S., Diala, I., Freedman, R. A., Lin, N. U., Solit, D. B., Berger, M. F., Barber, P. R., Ng, T., Offin, M., Isbell, J. M., Jones, D. R., Yu, H. A., Thyparambil, S., Liao, W.-L., Bhalkikar, A., Cecchi, F., Hyman, D. M., Lewis, J. S., Buonocore, D. J., Ho, A. L., Makker, V., Reis-Filho, J. S., Razavi, P., Arcila, M. E., Kris, M. G., Poirier, J. T., Shen, R., Tsurutani, J., Ulaner, G. A., de Stanchina, E., Rosen, N., Rudin, C. M., & Scaltriti, M.
Venue
Cancer Discovery
Published
2020-05-01
Volume
10
Issue
5
Pages
674-687
ISSN
  • 2159-8274 (ISSN-L)
  • 2159-8290
OpenAlex
W3013150216
Cited by
288
References
8
FWCI
11.63
Type
journal article
Language
en
Open access
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CoChat. (2026). Citation check: HER2-Mediated Internalization of Cytotoxic Agents in ERBB2 Amplified or Mutant Lung Cancers. https://app.cochat.ai/papers/10.1158/2159-8290.cd-20-0215
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Li, B. T., Michelini, F., Misale, S., Cocco, E., Baldino, L., Cai, Y., Shifman, S., Tu, H.-Y., Myers, M. L., Xu, C., Mattar, M., Khodos, I., Little, M., Qeriqi, B., Weitsman, G., Wilhem, C. J., Lalani, A. S., Diala, I., Freedman, R. A., . . . Scaltriti, M. (2020). HER2-Mediated Internalization of Cytotoxic Agents in ERBB2 Amplified or Mutant Lung Cancers. Cancer Discovery. https://doi.org/10.1158/2159-8290.cd-20-0215

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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