LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND
# ]$ Z& D+ K+ B7 F" K1 {THERAPE UTIC PERSPECTIVES: w5 n$ f/ [+ b( K/ T/ q, C* m
J. Mazieres, S. Peters
5 g1 @2 j: E7 G6 p; pIntroduction: 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
* s/ t8 o# P d( g% qoutcomes 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
- ^& H0 P# s& k% S) C, Xtreatment was delivered after convention al chemothe rapy. A total of 20 anti-Her2
( b( m3 I! ?* H% D, {treatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations
! o* n8 V+ h( K( p5 fand 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;
' R- s2 _2 A, e: u/ n8 Adisease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for
9 n G0 ?2 y" ?! itrastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to
N) X" e$ r+ f7 ~- k, Rlapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and8 k4 t) e: w0 Y
22.9 months for respectively early stage and stag e IV patients.
: Z# D4 d: y6 A! t* @Conclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,3 J9 W& M$ V7 m% m3 A
reinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .
: j2 f# C- S# O) ?8 AHER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative3 s5 k, T6 q) z& ?
clinicaltrials.
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