LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND
* F/ D0 A( O: l6 l& ^THERAPE UTIC PERSPECTIVES) N- e* m, I' N! s; w" P
J. Mazieres, S. Peters O: n5 Q9 ]0 ~9 L5 d
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 therapeutic1 ]* [8 m5 n# C. W, ?0 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" D+ B) p/ K7 M4 d; v1 g' Z
treatment was delivered after convention al chemothe rapy. A total of 20 anti-Her2
+ W4 H7 X2 l" m$ A, M8 Y' Ytreatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations0 u: Z X& F) S9 [" r7 `, |
and 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ; ^# X' Y+ n- ^5 L* }3 V
disease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for1 n O6 d1 j$ q9 g5 ~; [0 I
trastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to5 E/ i& u& @- g, ~. d
lapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and7 w8 L- H: `' ?2 j! a a
22.9 months for respectively early stage and stag e IV patients.! _, \" t' i% u
Conclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,* w+ }9 E/ w4 V# ^2 E/ W4 @3 w
reinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .( ]1 D* b v7 L9 _, A- l8 N
HER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative
# \& F; i, A) V1 M5 S7 a5 a5 h/ Iclinicaltrials.; I. d6 Z* Q2 r% J
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