LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND( G3 L+ _4 o1 Q) D$ b
THERAPE UTIC PERSPECTIVES( ~9 i! A% W7 K
J. Mazieres, S. Peters
" ~2 |$ }+ j" y3 b+ s" o( E9 UIntroduction: 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
- `7 P% Z6 `0 m: M$ ]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
) l# R# [6 H' b- y" A1 U7 X' utreatment was delivered after convention al chemothe rapy. A total of 20 anti-Her2
8 h3 p7 T3 t: S& j: H4 Atreatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations
$ j3 s3 C! }) C+ V& V5 Land 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;
: }6 _- F) ~. ?) ]9 Y# Sdisease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for! M1 j9 A/ b4 o* ?1 h. b
trastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to
M; i, ?. V) K+ c9 R llapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and
" d& Y+ X3 G! ~1 Z6 C# R22.9 months for respectively early stage and stag e IV patients.
6 {2 G" ]2 t5 jConclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,
9 l0 T# [/ z+ `4 ~( @reinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .
* q4 x% P! j* ^* ]+ Q4 m% B0 {4 O2 ZHER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative
O& Q2 C5 D& X5 p' Xclinicaltrials.
3 _1 B" f6 K# y |
显身卡
