LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND
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' ~" c' Y: m) W# x/ T! j* YJ. Mazieres, S. Peters# @. T3 {/ S/ E7 n2 @4 N' g2 c
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+ \! e5 |* w4 D3 B
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
& T4 [6 Q6 v7 ~) o8 Gtreatment was delivered after convention al chemothe rapy. A total of 20 anti-Her2
5 E: R2 C3 h% Y! `treatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations `& q* S, a, q; u n
and 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;
1 ~* R. ^! }$ R2 |disease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for
, z; k& v5 Z5 etrastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to
/ h! c2 W$ G- Hlapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and
$ m, _: B8 @2 d. t& f22.9 months for respectively early stage and stag e IV patients.
4 d L0 x6 k3 b X2 h/ s6 w5 uConclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,
/ i( C3 I& a2 T. C% p# O s! Xreinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .2 r( ^6 J: y$ e) T
HER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative
! Q4 r. n Y, F: [8 D3 uclinicaltrials.
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