LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND4 E! |5 b4 W; |) v1 c1 }$ c# i
THERAPE UTIC PERSPECTIVES6 R# s: w* @4 D* a* P3 ?) |
J. Mazieres, S. Peters8 g- L/ G0 K3 C% u8 _2 J1 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, {: [& R+ }. E
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% ]1 j' G/ x5 |2 Y8 z
treatment was delivered after convention al chemothe rapy. A total of 20 anti-Her2
" G4 c2 C: ^ f9 ~) h$ streatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations
6 G$ S* L, X! ~# nand 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;& Y" t8 Q2 R7 r& _+ n9 u" j% J% ?% Q
disease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for
# L& E6 [2 I, Z" k8 Vtrastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to/ L8 l# g- m, @* i: h: |2 J5 H, ?. U
lapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and5 f2 C) ]* G5 R/ U/ k* N/ j' d
22.9 months for respectively early stage and stag e IV patients.: ] k: q8 ^6 Z/ S* k$ k
Conclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,
0 Z" b& x1 [0 treinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .
9 z1 A( E' Z- r8 c2 ~. j3 kHER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative* M3 v5 Z- h6 g1 a
clinicaltrials.
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