LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND/ O/ A* V" |/ ]' R" s" g6 J
THERAPE UTIC PERSPECTIVES
4 h+ T! u) ~. v d1 K- K, mJ. Mazieres, S. Peters
9 }( W. p$ i3 r& b7 {/ I" E3 DIntroduction: 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
+ U1 ?8 \& _2 W& T# J4 \8 h# ]& Qoutcomes 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/ p, ^* o8 n5 O- n5 m* g; A
treatment was delivered after convention al chemothe rapy. A total of 20 anti-Her22 {# y! W2 \* F$ [7 }" h
treatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations
' K( c* x U* l5 @and 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;( L! x5 l* B9 \; j3 v3 O
disease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for6 N" n( o/ r4 E- A1 M
trastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to( T1 |; s' g* g# M4 c
lapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and
0 g' z: m) U: p& ?; a6 u$ K! F22.9 months for respectively early stage and stag e IV patients.+ L5 r" b& h% z) w, W7 d; \
Conclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,
]1 ]6 L5 t4 R7 Zreinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .: H' G. ~( ^0 u7 p
HER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative
1 \6 d' \& k7 {4 x3 @. ]clinicaltrials.
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