LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND }. Z! Y7 Z) x0 ^% K7 j
THERAPE UTIC PERSPECTIVES
" |: ^4 r! S& K5 e& UJ. Mazieres, S. Peters
. k7 }' B$ Y! u+ d. m, E" fIntroduction: 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
K9 a1 W1 c6 [9 ^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% J1 Z( h G8 J# l0 [
treatment was delivered after convention al chemothe rapy. A total of 20 anti-Her22 A9 L# @7 S( |. X
treatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations# }- N4 E' m7 Q3 E: m- j! f3 c7 m
and 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;- l' w4 ~5 ]( F
disease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for
; g* k% c3 N# `+ V8 g& dtrastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to
8 Y( m( Z N1 Y" j3 Olapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and; ?. B( l+ y8 @ J: K" Q% ~$ m- M
22.9 months for respectively early stage and stag e IV patients.
3 ^' L8 M0 ~. l/ w- I8 W& tConclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,
7 v- q* y+ |9 o6 Q* h+ ^8 oreinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .. @2 ^0 v1 N/ [9 R$ j) a' ~- e
HER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative3 ]9 [- {8 |+ v, M. z
clinicaltrials.# c( T( D7 a1 n+ C- L, c% {4 `
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