LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND# J6 n3 L! i I5 V
THERAPE UTIC PERSPECTIVES
0 _/ I1 @2 C% y2 sJ. Mazieres, S. Peters) ~5 s7 Q( \3 k _; G/ o
Introduction: HER2 oncogene is a memb er of the EGFR family, encoding atransmembrane receptor that drives and regulates cell proliferation. HER2 mutations are identified in about 2% of non small cell lung cancer (NSCLC) , mainly located in exon 20, and appear to be critical for lung cancer carcinogenesis . Very scarce data are available to define a clinical profile of the patients harboring HER2 mutated NSCLC. We aimed to study clinic opatholog ical characteristics an d therapeutic; u, d+ c: u f# E7 x
outcomes of patients harboring HER2 mutation in a large European series. Result s:We retrospec tively ide ntified 46 NSCLC patients diagn osed with HER2 exon 20 mut ation. HER2 mutation was mainly exclusive as only one concomitan t KRas mutation was des cribed. Our population was characterized by a median age of 60 yr (31 to 86 yr), a high proportion of women (30 vs. 16 men, 65% ), and of never smokers (24, 52%). All tumors were adenoc arcinomas (two with lepidic features). Half of the patients had stage IV dise ase at the time of diagnosis. HER2 targeted
$ i2 ]6 @$ i. H9 Htreatment was delivered after convention al chemothe rapy. A total of 20 anti-Her2- F- v/ e) K) E$ Y1 R5 W; `, S
treatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations/ G8 _3 W+ k3 X. l0 Y
and 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;
; f4 ]" ^! g) o' V `, n2 H6 v! sdisease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for/ v+ S1 c1 a, Y5 l) E
trastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to
- a1 n$ w: e1 m5 E% H2 Nlapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and
7 ]! d) s5 `" Y4 w, [3 A22.9 months for respectively early stage and stag e IV patients.
2 e7 u& x6 C) C. g9 L- ?1 `Conclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,. F' W: Y! A7 P
reinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .
1 u6 c: Y; r( dHER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative
6 y2 k0 s7 ]! oclinicaltrials.
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