LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND" t& B( l% Q3 j; F
THERAPE UTIC PERSPECTIVES
& n; r1 P. j) q% q9 a4 w4 M/ RJ. Mazieres, S. Peters
( z, Y; \% B) y5 z* u) OIntroduction: 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
& R$ J; E8 Y6 q; A2 \8 v0 @9 Noutcomes 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- _6 h% I B1 M
treatment was delivered after convention al chemothe rapy. A total of 20 anti-Her2, C$ _) P7 a6 g4 @2 {3 E* ^
treatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations
) X% ]7 Z3 i( v0 E3 A7 l }and 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;
' ?8 o2 u! F) d+ u: Edisease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for
3 _6 S c" b; c9 Ltrastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to& D4 y: R0 r. o; |6 A! `
lapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and& V7 ]: E" S3 T. u' p5 ^0 E5 X! g! ]
22.9 months for respectively early stage and stag e IV patients. M3 u2 l( b5 E Q5 k- F
Conclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,3 {/ T4 a7 ^+ f9 Z* M! b3 H5 U# t- N
reinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .# k% U) n. G- o# k4 _
HER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative5 M7 _$ k, U9 t/ j; Y6 U3 W2 l
clinicaltrials.6 K) h9 q c6 ?8 _0 u
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