LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND
) P [% _: ` {* O6 A' DTHERAPE UTIC PERSPECTIVES
/ `& X g# m# ?# I( ~J. Mazieres, S. Peters
1 U) }, d& E5 c ~4 x% k: 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
, n( P: L2 L) b. y7 a" Routcomes 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
1 f$ R; k3 b2 \; E8 ]treatment was delivered after convention al chemothe rapy. A total of 20 anti-Her2; a# Z3 j. e% j. m
treatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations9 `4 M6 q" h5 A5 p
and 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;
& e, |/ ?( c5 Z0 d3 Rdisease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for
7 X) I; ~: y' O, u: _trastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to2 [3 ]5 W* u9 _( `, |
lapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and+ H5 v1 x5 [% R6 X: h* \
22.9 months for respectively early stage and stag e IV patients.
- E- Z' j) \# l1 }4 L. T* h: ?5 W( iConclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,
. K7 R+ B4 ^' b) e. C" U3 b; greinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .
; t' r6 y4 i K, n9 wHER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative' s( p' t9 H" t! e% u9 C& w4 ]/ r, @
clinicaltrials.& M8 E/ y( h/ }' g8 L
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