LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND; Z' h+ N: x# c- @/ v- w5 V
THERAPE UTIC PERSPECTIVES
9 @. y3 `. M2 l1 Z! X: IJ. Mazieres, S. Peters% _. S+ U, V# e# {" _' X' ~4 u
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! }& j' x! Y' a0 c' V
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: c$ x1 R8 T' V- x" t
treatment was delivered after convention al chemothe rapy. A total of 20 anti-Her2% W' L. ^1 g6 L2 }
treatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations* L+ t8 {+ i4 B% z* Z
and 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;
& H( V" R6 M% j5 B% b# _( n( ]disease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for5 R9 C' q/ j( d( r1 J# m' X" {4 `
trastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to. y1 i* _ @5 p7 N B# y
lapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and. n2 V+ i# ?! a$ T' J
22.9 months for respectively early stage and stag e IV patients.9 D$ g& z, h6 w" q+ Y* H
Conclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,6 b. e) Q& w! e
reinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .
& r9 L; H( M6 G5 t6 \4 ?HER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative
0 o6 X- X' [/ _ R' gclinicaltrials.
! j+ ~6 R' E5 u, u3 l E |