LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND
/ `* c4 c3 I4 y1 ^# \5 V. XTHERAPE UTIC PERSPECTIVES
: Q, g# W% \: @# hJ. Mazieres, S. Peters0 Z& V3 a: l( A
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( N) O! b7 e3 k- T' n2 I
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
+ E# I3 \+ W5 p2 d9 X$ Y0 |" ^: Xtreatment was delivered after convention al chemothe rapy. A total of 20 anti-Her2
- Q# @7 k- r& V: b6 S# Etreatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations/ K$ v* N2 D( H2 B$ V
and 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;
4 N4 C$ k @; M8 a! Kdisease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for6 C- R. }/ B3 u6 p9 a4 w+ a9 n' p& ]
trastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to
5 M# _ \2 V% e1 W& @2 llapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and
; o+ a; t& H+ ]* ~7 r22.9 months for respectively early stage and stag e IV patients. y5 C8 ?9 ~1 l' v' n1 M4 Y6 B/ i
Conclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,
; n5 @ m) B8 X- H, k2 A4 A& ?reinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .
% R5 [) h2 t" ]1 n+ xHER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative
% M& C; p/ q4 P, I5 Cclinicaltrials.
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