LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND6 F4 Z& y' s0 C$ e% m$ ]
THERAPE UTIC PERSPECTIVES+ ^: u) w+ r7 S! ?8 y, P( G
J. Mazieres, S. Peters, r" d& F- v# ^- ^: c
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% Y5 b$ d3 m( C4 x. @
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; d9 r# y( Z0 C) \, L5 Y
treatment was delivered after convention al chemothe rapy. A total of 20 anti-Her2
+ \( q& g1 U% A. g; ]1 D3 u0 \3 J% `treatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations7 N$ s1 z$ R1 w" H& w
and 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;/ i; o. n& D# a% R" K0 }
disease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for
& ]+ p2 X( Z7 b; k* K' T0 ztrastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to
# c- A4 u. i- z$ B I5 Vlapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and
! Z4 ?+ _' s9 C) w/ s; }. ?1 v22.9 months for respectively early stage and stag e IV patients.
# m) `( y+ i! W+ l- c4 ?Conclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,9 [ D& `" M" G- Z- I
reinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .- T4 T- `! Y& b, i5 X- d4 T' f" O
HER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative
. e% o9 {, F) e: N+ e6 Z! _clinicaltrials.7 [6 Z' ]; _. \! E; b( C0 W7 q, t
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