LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND6 R% R$ t- L+ }: `; }2 K0 ~
THERAPE UTIC PERSPECTIVES+ F7 x6 h, M; L0 Y7 a3 k6 q
J. Mazieres, S. Peters9 `5 R8 r' N, J4 w
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# K4 s8 g8 Z* J( ~2 L
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/ `! \ d5 `* F1 p" ]
treatment was delivered after convention al chemothe rapy. A total of 20 anti-Her2
6 X2 J: }; ~, q9 s3 utreatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations
9 R6 w7 w# p% `0 D1 R3 X" @and 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;$ j: Y) b" q+ {# g. b0 h
disease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for, M1 v* L G7 h) k
trastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to# a8 B/ c2 }. D4 S9 Y, j
lapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and, u- D% m* v9 h" d" x. \. f% q4 x
22.9 months for respectively early stage and stag e IV patients.
$ d, f: ]& u# S' N- S. ]7 CConclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,( l& C' M* e/ P+ ~# [
reinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .! G5 `2 m+ Z" ]( P
HER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative' F- q5 W5 a0 n+ n, A' m) h
clinicaltrials.
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