LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND
) o5 X; L9 a+ H3 q; `, W2 DTHERAPE UTIC PERSPECTIVES7 n! L. f3 @6 I4 y4 }/ s3 Y9 \5 L( a
J. Mazieres, S. Peters* q Q9 C' x, Q c+ M
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+ S- X+ z" j8 ]' Z/ S% O
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 targeted8 m2 {* l, Q. f" h
treatment was delivered after convention al chemothe rapy. A total of 20 anti-Her26 Y3 N w0 s5 v% f, K: F! T
treatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations
. j. M& g: L5 i. g. i0 Iand 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;" C* u- u2 M) s- s
disease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for) x) D: B' z, c% {7 M( u# v, L
trastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to
+ l% ]- d. o/ Y* Qlapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and9 E! X( h# b$ Y9 ?3 g" Q$ Y/ c
22.9 months for respectively early stage and stag e IV patients.
0 T% @" G _; S K$ h) }" y/ AConclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,
+ i7 b! T3 o6 t8 k* K# ureinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .$ N$ k0 M* r7 F$ X" C' K1 n6 d
HER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative
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