LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND
9 Q y" u- K7 d! ^+ Z1 d. X" ]THERAPE UTIC PERSPECTIVES
( Y) p& k1 v- {J. Mazieres, S. Peters
6 ?2 f2 |% m6 oIntroduction: 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
& G; k6 K2 {: b2 D5 i# j0 Houtcomes 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% U- U* i( R* G( @
treatment was delivered after convention al chemothe rapy. A total of 20 anti-Her2$ u( T( v7 D3 ?( ^' r
treatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations' }5 K) o' R% S
and 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;
5 b4 G% e8 ~: Zdisease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for
% `* i/ P7 B" W9 L( u9 X# `trastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to4 O* | c! y% _! k
lapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and
' R) s3 J1 t+ C- m$ @22.9 months for respectively early stage and stag e IV patients.* m) B0 v' h' Y3 v- R7 J4 A4 R" l
Conclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,
5 k) i0 K$ f( ereinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .
; x E* O. y5 V9 V0 THER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative% \1 d# b- [6 G3 v4 |4 ~1 J# i
clinicaltrials.- t3 z) k# e& k
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