LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND
7 D% ?+ m+ V8 m* }9 j4 h4 wTHERAPE UTIC PERSPECTIVES
$ Z p1 J# _& ^8 Y% U/ H5 [( T0 IJ. Mazieres, S. Peters
7 K) |7 i- f5 ]# mIntroduction: 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
- w6 a5 e, O$ {0 X( Uoutcomes 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 targeted8 U# \+ z# \: I: ?1 H+ j5 s
treatment was delivered after convention al chemothe rapy. A total of 20 anti-Her2
: o# l' l: T. f/ F q9 ctreatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations" e; O$ F) Q( D( {$ C
and 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;
% E- e- w4 X4 m% s' s( T& Y$ xdisease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for
2 P6 w$ l4 C6 }6 } B- f3 ~0 m, `trastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to( q" M. d- f3 B& w+ |
lapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and
5 ~4 Z @4 @$ k: U$ e& T Y22.9 months for respectively early stage and stag e IV patients.
0 J3 ]" Y/ l7 d4 x4 O. qConclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,. k3 X \* H- w# Z$ X. @
reinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .
' x& v6 L8 {2 N! a* E! X4 W. CHER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative3 ^7 r, F( o7 X* j
clinicaltrials.- r. Q0 U% Q4 L/ `5 F" h- ]
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