LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND! g, J: v% T1 q' g
THERAPE UTIC PERSPECTIVES
5 j D) }$ M% Q9 \$ SJ. Mazieres, S. Peters% }$ w$ m' s6 |0 S
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 therapeutic3 }" M3 j0 ^6 Y. ?# B! ~
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
T0 M c# c8 k9 z# h$ ttreatment was delivered after convention al chemothe rapy. A total of 20 anti-Her2
, S7 U5 I2 `4 \2 u. Xtreatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations
& C6 b8 m6 m1 k; M" ?3 mand 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;3 `; b# A) s8 M: z {( p
disease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for
- G' S6 _6 j, _( R/ @& D$ j5 e Ptrastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to
, A; o$ l0 v' N% nlapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and
. x: y% [9 y& R0 w* T, E% o22.9 months for respectively early stage and stag e IV patients.) X* W! o8 i/ u1 d6 N5 K
Conclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,
$ \8 C3 }) ?/ b# a* Preinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .
3 K* X. A# L0 b1 |HER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative% v# G0 _4 Q) x y$ d3 o
clinicaltrials.
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