LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND
9 y7 H2 X2 H8 J* N M8 `THERAPE UTIC PERSPECTIVES5 ]+ A7 [2 h X8 J* Z8 W2 h2 I% z
J. Mazieres, S. Peters! D2 C: }, t9 z
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
1 K k. g$ ~: loutcomes 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
. J5 C0 l `+ I+ W* Wtreatment was delivered after convention al chemothe rapy. A total of 20 anti-Her2 x! ~; D9 g' d. M( X9 C! E; O6 B
treatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations
C5 I& w$ V$ U1 A% z p% H# Hand 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;
~3 t8 S) z) e! G$ tdisease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for+ c( r; V8 @' J3 s
trastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to
% L6 n. H' ^$ ]4 o$ W$ r" N! }% flapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and, V/ M: @- P! ^9 E( a
22.9 months for respectively early stage and stag e IV patients.
% A9 N4 v! u+ m/ wConclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,
+ j/ e1 {; h( w' k# T6 greinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .
& S2 k& _0 e. `6 S+ N5 C0 uHER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative
' V. u- o; `" @, s7 jclinicaltrials., P6 o1 }) \0 X' v) o
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