LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND
: Q x: @# C4 u- K& g4 x" y- lTHERAPE UTIC PERSPECTIVES1 N8 x) `$ o0 b X, z
J. Mazieres, S. Peters, O% o8 I$ b& j# h( x9 i
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) j2 P5 G+ Y$ r% u
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
8 H" A" v; l( l! q9 [$ |* ]treatment was delivered after convention al chemothe rapy. A total of 20 anti-Her2
% R/ a* ^0 U3 `treatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations( ]( g4 `: p A5 T
and 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;
* D2 c8 i: k3 I6 Qdisease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for, B7 ]' s0 K6 |1 k5 p" \* E5 y
trastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to) u' u. m& Y$ ]$ c5 x1 p7 Y
lapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and; M+ ?. v; m+ X" i4 a
22.9 months for respectively early stage and stag e IV patients.% X& T! B, s" e: k
Conclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,! N. `: Z5 e3 Q% R7 D: k" @, [! \
reinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .
5 S0 O6 n4 I8 F" f( W9 cHER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative
1 i6 l( k& c' B) z5 Cclinicaltrials." \+ Q t% o' {2 _, A
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