LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND7 J! q9 f7 j$ N! L1 x8 F
THERAPE UTIC PERSPECTIVES
1 z* ^: _6 T3 [J. Mazieres, S. Peters
2 o1 l4 Q% |, K/ u+ XIntroduction: 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( x, Z! g8 d1 t b) ^7 W+ g& S
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* R" y/ n) ]" b z$ I$ M4 N3 X/ K
treatment was delivered after convention al chemothe rapy. A total of 20 anti-Her2" R- H7 m! k7 i
treatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations
* A9 \, N4 o* `* p: e/ R: Sand 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;
a" _1 B) }/ L5 y" E6 m2 ^, A+ e7 m( ]- gdisease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for, g! t' M; W: f E5 Z" D
trastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to
5 S' N$ H' v/ D. y; vlapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and
" l9 o' V1 X. D9 i2 Z4 c22.9 months for respectively early stage and stag e IV patients.0 O k2 X. ~; F# E4 X* u
Conclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,/ E- @6 k, T. }& N
reinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .3 n3 O9 D6 z) J
HER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative2 l' b1 O* J" b9 y( x2 m- X; k, T
clinicaltrials." L1 ]6 l _/ E3 [ ?8 _
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