LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND# z( f4 J2 c1 Y' `0 q
THERAPE UTIC PERSPECTIVES
9 }9 W, \$ i8 i8 b! bJ. Mazieres, S. Peters8 h' N0 p; P# F* R: i/ \
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
8 q& @* p: s5 A6 ^9 B4 ` Poutcomes 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
5 K) s! G5 p1 z# U7 I. l" U# o( vtreatment was delivered after convention al chemothe rapy. A total of 20 anti-Her20 N" L# i. t5 Y/ w( ?) B
treatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations0 S, O; |) J+ {' p( e5 \
and 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;3 P9 ~; O- e3 C9 H
disease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for2 R. C# }7 n+ g5 B* w8 j
trastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to, F, [" v$ M8 n$ g @: g4 p! n
lapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and
' o9 E0 v5 b- Q, w2 i* U8 s: C22.9 months for respectively early stage and stag e IV patients.
* g+ g) y5 y2 }# F! |, J6 s3 a& a9 [Conclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,! g! Z9 e6 f& T" P2 ?
reinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .( h' {( Z9 ^! Z
HER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative
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