LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND
3 f Y& l0 ^6 y/ C6 k- s. s+ z% `THERAPE UTIC PERSPECTIVES, d3 p0 K/ d& i ]2 `
J. Mazieres, S. Peters
- a1 l% s: y0 b; ^- G$ m& v" }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
" X0 j, @9 v9 W) _0 y0 P! Uoutcomes 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
+ M/ J0 @$ u0 b! I6 @# Gtreatment was delivered after convention al chemothe rapy. A total of 20 anti-Her2
! ~% P& f3 E9 }treatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations" w b0 z7 b2 T: W7 i
and 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;$ E8 N0 e1 h# Y6 s) c1 f# O
disease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for
! R4 u* G3 V* H) U0 o0 mtrastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to
# o4 n; ^) J/ ^) e6 H( P Elapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and3 g: Q; {% D( K5 y: A
22.9 months for respectively early stage and stag e IV patients.+ S' b. x4 S" A% o! Z9 a! U, J Z0 n
Conclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,
$ S6 o7 W/ [; breinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .
! s7 m9 |7 ~1 t# ]) AHER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative' k. u) m$ V& a; ~
clinicaltrials.0 ]) b9 a4 U$ w) q
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