LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND
( s0 f7 Q& e9 L# n6 cTHERAPE UTIC PERSPECTIVES
' d) _6 o) t4 V, g- W7 IJ. Mazieres, S. Peters# A( r @! M: {- O7 J3 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( i2 Y" a7 @. k! {( ^
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 targeted4 _4 Q. e3 @6 i7 K, i0 Z |) M, @1 ~
treatment was delivered after convention al chemothe rapy. A total of 20 anti-Her27 ~# k0 P3 ~9 j
treatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations, a. ?' r4 h; v
and 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;4 v( f+ O7 s; ~- _
disease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for
; {$ m* n8 M& htrastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to: s0 B+ r# X% v: ~
lapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and& i* t5 I) S) P8 \
22.9 months for respectively early stage and stag e IV patients.0 n2 \3 J# c0 X! T+ r
Conclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,% c6 Y% @5 S) J
reinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .- v! ]) d, K7 O/ o* A
HER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative
& [8 A% T) A9 L, Jclinicaltrials.
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