LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND' ~# P2 E! `5 Y0 w4 I
THERAPE UTIC PERSPECTIVES/ o8 }$ a s1 M# p
J. Mazieres, S. Peters9 u. Q4 [3 f1 R
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+ H* F T$ a1 g. `% T5 a7 w6 C+ D
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 targeted9 K ]+ h# C/ a( W/ W3 W
treatment was delivered after convention al chemothe rapy. A total of 20 anti-Her2
3 o {. m/ E/ A/ D: U$ ]- Xtreatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations: z. @# D$ p' a( F \
and 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;
! c8 S8 q) J- P; M+ G) rdisease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for
, B2 ~1 H |# N q3 I( Otrastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to
0 `% p/ o. B2 N$ Hlapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and
4 \ H0 o& `% o8 V! B# j22.9 months for respectively early stage and stag e IV patients.* D* B& ]# O# F* s' N
Conclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,
9 y3 J# ]) Z) w0 Q, I `" ~reinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .+ c8 ] r4 _6 h# @! Z. H1 g6 m
HER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative
4 g" {* X9 j! Jclinicaltrials.
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