LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND
- e+ V6 ^. Y+ H" }& jTHERAPE UTIC PERSPECTIVES* S3 o) E; O/ A' e' Z/ |* j
J. Mazieres, S. Peters
9 M- s" @2 [1 M! m0 `9 G1 k6 ]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
, J8 e: {* c* i3 p" k% D4 G9 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 targeted3 d3 | p% G A+ e- |0 _
treatment was delivered after convention al chemothe rapy. A total of 20 anti-Her21 X6 o' K; C0 W; B) j
treatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations& h' j: y S; T1 w% N+ W
and 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;
8 q% g% O6 X0 {& v% S; mdisease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for
. K7 L# C" l3 l( g1 q9 m0 s# jtrastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to! t8 c. Z, G* F
lapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and
: k( F. I! T5 {, M! e$ g22.9 months for respectively early stage and stag e IV patients.; [+ p3 o3 c8 b: a# u4 |, [: M5 |
Conclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,. a& W. z5 E# I6 a
reinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .
2 O# q1 L5 ~4 E* y& W8 ?HER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative0 L4 H E) D! J. w& J
clinicaltrials.+ Q4 [4 v5 s$ A/ c, `' V! u& ^
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