LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND
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@, R- |: f; \) l) g% eJ. Mazieres, S. Peters; R& y6 {2 E, K8 p( b
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" T+ l8 ?. F- 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 targeted0 J* \& h4 Y5 }7 T; S
treatment was delivered after convention al chemothe rapy. A total of 20 anti-Her2: f0 T& s; U) T: q
treatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations
& V$ T/ a9 ?! a0 p3 Z1 j& j$ @and 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;! P1 K+ X r% F! j1 ~$ X
disease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for
* I, j; {/ B/ H6 H2 ktrastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to5 n8 E, e4 S p3 b* c# p9 m
lapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and
4 z' I! o4 {2 ^22.9 months for respectively early stage and stag e IV patients.8 {; f' N* \6 O4 i6 }
Conclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,
8 b1 e# T O8 [/ Z9 E' K1 vreinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .+ {8 M5 h( q1 ^. \! s# P) r8 H
HER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative
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