LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND
+ }& z9 u, o% X+ h" X" w- b$ JTHERAPE UTIC PERSPECTIVES
5 d ]! c4 f3 B: U0 m+ H0 lJ. Mazieres, S. Peters
1 Q, z1 @- G& Q. t# aIntroduction: 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
% R/ c& Y: O( o J/ koutcomes 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
; ]4 j$ P2 I$ m8 p/ Streatment was delivered after convention al chemothe rapy. A total of 20 anti-Her23 ]4 o2 k& A$ r! _& Z4 O1 X
treatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations
' J# l& Y! k+ N5 v) Uand 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;
z8 t. r' n6 k1 X: n3 Odisease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for b+ Y4 X8 W3 M2 n6 Y9 {0 E
trastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to
2 P+ B- E, V- v8 w+ J8 Plapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and2 ?! L9 {# j& W _ {3 c7 @8 E/ ?
22.9 months for respectively early stage and stag e IV patients.! c9 ~6 e! Q( w: `$ \# @" D6 {
Conclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,
- @% g# j4 M8 n3 \2 Zreinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .
+ O0 q) E5 `+ T5 W3 @6 c3 hHER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative
) e; a' F( ~' ]; S* B6 fclinicaltrials.* Q' W! O0 R' }* p* ^6 Z/ W* S
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