LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND- ~5 O2 h4 y' |8 A, G/ v
THERAPE UTIC PERSPECTIVES) U9 ]: k3 ~# P! |" z5 U, m1 I
J. Mazieres, S. Peters, F9 t) u" {% n6 f2 p* {
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; [' O P" m5 q, ` y
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# o+ ?& x/ u0 H7 |
treatment was delivered after convention al chemothe rapy. A total of 20 anti-Her2
" [2 i1 O D9 c Vtreatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations
9 C. m% t3 u: ~* ]/ c1 x: B' Kand 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;
K" v' S3 E3 Bdisease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for
! G$ \9 Z; e( o0 Itrastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to
% `1 ^6 k) E6 O/ T2 b+ v* q A i3 ^lapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and8 C4 ^" G9 V' Z8 N, \
22.9 months for respectively early stage and stag e IV patients./ Z, T/ e0 |/ m4 o/ B# ]2 w% j
Conclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,. W$ Q2 K* ?7 q5 x8 ~7 h
reinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .8 x3 ?2 ~9 U. X- {" A
HER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative
& b8 S7 }6 `- O6 i2 Cclinicaltrials.- I m' m* N" y% Q y4 Z: w" s
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