LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND
3 S y, a) W0 M" F) \) ^- rTHERAPE UTIC PERSPECTIVES, h+ G4 D- ^8 k8 i
J. Mazieres, S. Peters- p& h( P7 u" _5 H0 h# ]
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
5 Z! r1 o; [' G5 A: _. }1 Foutcomes 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 targeted3 _; o6 I4 l: t% w5 ?* e
treatment was delivered after convention al chemothe rapy. A total of 20 anti-Her2
4 o/ k7 B: H/ ^treatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations. S* W! C* M+ m" t" |
and 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;+ P+ m" i+ `6 y1 h; N
disease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for: x' ^5 c7 G; A. f: z9 b3 ]
trastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to
% ]) T- l" l' g1 Z7 g( [& l: N; dlapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and
" g, I* N$ T; d& z+ G; y" |3 q22.9 months for respectively early stage and stag e IV patients.; T/ {- L9 |2 d2 r3 V
Conclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,
0 R" I4 R# h! ~. qreinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .
0 G/ a: Y1 l8 q, {& z+ Q0 [4 lHER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative' I9 e7 u# i3 [5 k% K5 _
clinicaltrials.% G1 G0 m% a2 U( R3 }) \2 Q$ j
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