LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND/ S) [+ k5 p: a2 z
THERAPE UTIC PERSPECTIVES
4 g- h* a+ s6 i/ `6 \+ e5 ~* x" CJ. Mazieres, S. Peters' n2 v% t: n0 o& Q* B3 z- `
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 therapeutic0 X7 U! m6 t, @) o I2 J
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; b- Y( x$ A, d2 D; @5 s2 e L
treatment was delivered after convention al chemothe rapy. A total of 20 anti-Her2
# s0 k1 d% A2 n; A% ktreatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations
; f, Q( G( l2 d, X8 M2 {6 ^and 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;
8 ]0 U% M+ M/ C% ?- }7 |disease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for
' ]& B8 X' H* E$ g% Otrastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to# u G! I1 q9 J2 P
lapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and. F; Q' \$ w* f+ P4 C
22.9 months for respectively early stage and stag e IV patients.
, }% t( X ?, Z9 q( e1 nConclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,
/ q" U! N4 |. Z" a, Vreinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .
% O9 [" n" Y- L5 |HER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative/ E( C2 p8 w. ]1 J
clinicaltrials.
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