LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND) |3 S( Y$ P$ I1 b2 n) ]
THERAPE UTIC PERSPECTIVES( _5 z5 c" x# v9 Y3 n" h: P
J. Mazieres, S. Peters
5 J; p p' b- B$ p. `; [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
% E3 j7 B& T2 g/ k0 X/ Houtcomes 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 targeted4 J+ Z7 j0 F4 o5 h
treatment was delivered after convention al chemothe rapy. A total of 20 anti-Her2" e+ c+ N4 z. R5 j
treatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations5 j9 S- t2 d6 q! @8 Q: z2 Q
and 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;# k6 v' k# Q) T% A$ ]
disease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for
G: _: v6 U; T1 ytrastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to4 C7 U% { y9 D6 P3 G# C7 }
lapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and$ U8 m9 ?% R& H; u# `
22.9 months for respectively early stage and stag e IV patients.% f' N8 A5 n- y; Q: }* v
Conclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,
/ Y: ^1 {% |3 b9 d) [0 y; freinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .3 \- }2 a4 @1 Y: g4 N
HER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative
, @5 {/ _# v5 q0 N6 ?clinicaltrials.
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