LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND6 |9 |8 V5 v+ x: I
THERAPE UTIC PERSPECTIVES% o7 p' \6 ~2 j# Z8 M/ n
J. Mazieres, S. Peters
9 c) Z+ q3 J* s+ ~9 A$ IIntroduction: 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
- A' b) d3 V" ]! a4 D1 [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
: w) h1 l/ P; B: v! Z, xtreatment was delivered after convention al chemothe rapy. A total of 20 anti-Her2
3 _6 a4 r( K) E" Jtreatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations
/ ? X% _+ P4 b8 f( H$ k; pand 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;
+ t0 [; d$ K/ A% m) ]8 Mdisease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for
" F* m q3 T1 L% Vtrastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to+ R9 N- \" z& {3 L+ z; b0 c/ X
lapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and
% E' |! H. W+ T22.9 months for respectively early stage and stag e IV patients.6 e& X. U+ ?! J% h7 p
Conclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,
v1 q$ `+ s+ s* R2 n4 ~reinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .5 K; t/ \3 Q. O3 P1 d
HER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative
9 D7 b6 k5 w3 jclinicaltrials.' j3 `; t: F) `; _8 N- o
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