LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND; F; H# B K$ d! t
THERAPE UTIC PERSPECTIVES9 |, l I3 t! c; v. c7 L
J. Mazieres, S. Peters
# K7 J- F% C. ?) ]1 yIntroduction: 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$ c% @: M( B9 z2 J+ W
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+ t8 Y1 S% U7 `9 \7 r& G8 G
treatment was delivered after convention al chemothe rapy. A total of 20 anti-Her2( U% |! w' _$ P/ V0 \) i* E* A
treatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations
; k$ V2 E6 T1 G! Wand 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;3 a- c0 t& _$ K! j
disease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for, K& a* x. O' R, t8 \
trastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to, A+ ^% D j& }0 O0 w ^. L" L
lapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and9 Y4 Y) A" ?0 \) t+ k' {
22.9 months for respectively early stage and stag e IV patients.
, s: ~& S% p* a+ u. ~: J; s% c* V% gConclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,
0 Z( V* F2 q3 Breinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .8 P1 O' U4 m& X. R; |( @1 I7 e2 i
HER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative
: X% e ^& Q' U7 Cclinicaltrials.
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