LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND
Q! a; S4 F7 uTHERAPE UTIC PERSPECTIVES0 z1 a5 L$ F! L4 }4 t8 y
J. Mazieres, S. Peters4 `: o' _) J: v
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% k. y$ T+ R8 B k5 w, Q
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 targeted8 [' K3 m! ~/ u# C9 I5 A2 _8 c' |
treatment was delivered after convention al chemothe rapy. A total of 20 anti-Her2
; o- z( U6 J! Q, @/ Qtreatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations
3 t6 e' _9 c) h( J. p: `+ p& qand 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;
7 \3 L! r2 D, pdisease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for! a, j& Y7 |; F' ]& k1 P
trastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to/ @: ?5 a3 ]) C; ^; d
lapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and& J, L" S5 i1 l
22.9 months for respectively early stage and stag e IV patients.
0 {& h6 x0 `" U- |9 DConclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,
6 N& T& U V; u7 Yreinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .; f9 M9 D6 t8 q! I, [
HER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative" l( E4 Z- V, ^/ q: J
clinicaltrials.) ^+ e- i" L# M6 u/ H
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