LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND
. K9 Y' ]! u' e0 u& `THERAPE UTIC PERSPECTIVES
( [8 u: f* q2 I+ d: B; F7 e' P3 yJ. Mazieres, S. Peters/ i S& C9 ^( g: w- [8 f8 x
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
* }3 i. Y; F1 \; U. \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 targeted4 q* G, K. M6 U7 p( O0 N5 |* c
treatment was delivered after convention al chemothe rapy. A total of 20 anti-Her2, q3 m2 p; g6 @* P! h
treatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations9 W* O* h3 ]9 I8 q
and 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;# e- d o m3 g: G$ \' b' T: N+ y: N6 J1 c8 ^
disease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for
9 I/ ~+ \* U3 m' N6 ttrastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to6 d/ D! y( ?6 w( }& n" a
lapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and& x8 Z% a, v7 I g; l. v& j
22.9 months for respectively early stage and stag e IV patients.9 Q3 v' L' x5 O2 Y7 w
Conclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,2 z( c$ A6 X+ X" O+ b6 _
reinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .6 P4 H! ?" o" Z' v
HER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative: u7 J8 F4 S2 G3 d7 D! \
clinicaltrials.# j" A; w) i8 W7 b0 _# C; S
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