LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND
' O" Y' L0 D2 O; z* iTHERAPE UTIC PERSPECTIVES2 Z' ^* N' y! @) _2 [6 s, `* Y0 b
J. Mazieres, S. Peters
; \, ^9 q5 j CIntroduction: 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
y: F+ Z0 N t! ~9 j- Qoutcomes 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
) C! \ \3 B# p1 c6 R- wtreatment was delivered after convention al chemothe rapy. A total of 20 anti-Her2
+ @3 A" n/ Z- u& l4 Ntreatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations
4 c+ k; h# _' c# P# rand 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;
$ ]; g/ E# n# `) edisease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for3 B3 b4 R( T1 g1 f8 A1 |% f" h3 K
trastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to
E& L+ d. b6 i I7 |% ^- alapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and
1 b- B% n& }4 G& a' _# a& z3 q \22.9 months for respectively early stage and stag e IV patients.
$ z& ~# ?9 q0 C" T% _Conclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,9 I+ c4 G8 z$ U. E" `; H+ W
reinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .
6 F! e2 [' ]% dHER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative, [6 F, }6 z t h- }8 i
clinicaltrials.) x4 r9 ~- L/ j3 [3 h" n& l# [
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