LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND
$ ^0 m% U( Y. t4 sTHERAPE UTIC PERSPECTIVES& j% o* p }. `& k; L0 A% A
J. Mazieres, S. Peters
2 T Q1 s- T7 R5 b! _6 UIntroduction: 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
+ L; m+ d. |& a( S# w# _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
; U' w, k& |* F. |0 ^- X5 X# K I/ Vtreatment was delivered after convention al chemothe rapy. A total of 20 anti-Her2+ W/ k, u: I6 V6 \! M/ x: e
treatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations
( f7 k1 H7 U4 yand 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;
$ Q3 N6 Q4 a O) Y) ?* }, _5 r! ^3 Jdisease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for
: L9 S5 {! C5 O- X3 d6 Strastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to
6 E8 r( t4 I8 \$ @lapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and5 e. b3 ], C- }2 [. j. V. x: @% K
22.9 months for respectively early stage and stag e IV patients.: M: O9 t. Y0 r. v' q; p) I- ^
Conclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,6 T3 `8 i2 P t( o' M& e2 @) Y
reinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .
# M# a! j$ t; E3 uHER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative
/ g+ M) t/ o1 V1 J3 C* z& O$ t" cclinicaltrials.0 M" g( n& I% A
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