LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND* g0 Z" _7 M" O" U
THERAPE UTIC PERSPECTIVES
5 U2 c0 D3 e1 P O9 hJ. Mazieres, S. Peters: M; g6 L; I t+ J2 L2 D$ C
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
2 R0 d+ t' M) p( n, goutcomes 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- j0 j* l( ? l- {3 J$ v1 v( |
treatment was delivered after convention al chemothe rapy. A total of 20 anti-Her2' r4 c% e7 f; m8 @- q: }
treatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations
s" r, G2 s* Y& {4 v# D4 z; Land 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;
; \3 Q2 Y8 d# n: ?8 y& H4 mdisease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for2 c) H, N- X2 R& j5 Q% l1 V! C' y
trastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to
; q4 O0 a0 W' S, o v0 Vlapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and" P* d; Y$ M$ r; J& V% }. e
22.9 months for respectively early stage and stag e IV patients.
) I5 y* y2 ^/ a2 i0 Q" l1 FConclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,5 a: Y: Q) z& n2 v6 f
reinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .; T# X) j4 t, o- h, L8 I
HER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative
' g! O0 i5 l" Z1 rclinicaltrials., [6 B0 W4 v, V% L4 M
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