Durable clinical benefit to trastuzumab and chemotherapy in a patient with metastatic colon adenocarcinoma harboring ERBB2 amplification
Umut Disel1, Alexis Germain2, Bahar Yilmazel2, Huseyin Abali3, Filiz Aka Bolat3, Roman Yelensky2, Julia A. Elvin2, Doron Lipson2, Juliann Chmielecki2, Kai Wang2, Philip J. Stephens2,Jeffrey S. Ross2,4, Vincent A. Miller2, Siraj M. Ali2, Thomas J. George Jr.5
1 Adana Numune Education and Research Hospital, Department of Medical Oncology, Adana/Turkey
2 Foundation Medicine, Inc. Cambridge, MA, USA
3 Baskent University School of Medicine Adana, Turkey
4 Albany Medical Center, Albany, NY
5 University of Florida College of Medicine Gainesville, FL, USA
Correspondence:
Umut Disel, email:
Keywords: ERBB2, HER2, trastuzumab, oxaliplatin, colorectal adenocarcinoma
Received: June 15, 2015 Accepted: June 30, 2015 Published: July 1, 2015
Abstract
Somatic ERBB2amplification or activating mutations occur in approximately 2-5% of metastatic colorectal adenocarcinomas and are presumed to be oncogenic drivers, but limited evidence exists to suggest these lesions are sensitive to targeted monotherapy in patients. Here we present the case of a patient with advanced CRC with pulmonary metastases, who had progressed on both standard of care cytotoxic chemotherapy and anti-EGFR targeted therapy. Comprehensive genomic profiling (FoundationOne®) identified amplification of ERBB2and a TP53 mutation in the metastatic lesion. Treatment with trastuzumab with a chemotherapy backbone elicited stable disease/minor response in the patient over a one year course of therapy, reducing tumor burden and significantly improving quality of life. This report demonstrates the application of personalized targeted therapy guided by comprehensive genomic profiling in metastatic colorectal adenocarcinoma.
