LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND
1 h! B; C, |2 D4 G6 H8 wTHERAPE UTIC PERSPECTIVES) O' u0 E' u- W* J; _
J. Mazieres, S. Peters7 E4 @( }' r5 N* E
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* M4 t+ W3 } J5 B5 P& S- C( _7 t
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/ O# Q" ~5 w5 S3 G
treatment was delivered after convention al chemothe rapy. A total of 20 anti-Her2
U% _% D" j+ h N: g9 mtreatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations, ~& Q6 ~/ h. p$ V- B* N8 g
and 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;, H8 |1 E- r9 p6 j+ ^3 v' y& O
disease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for
% m, X0 a4 `$ M* \( N) {$ Itrastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to
3 A- l3 U* \+ H+ ^7 C5 B D6 q" q4 ilapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and
6 n& v5 D7 G/ N: p3 x8 f3 J; d22.9 months for respectively early stage and stag e IV patients.
$ {! A2 y9 g4 I/ @$ i% ZConclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,5 k4 g6 W# q1 i# V
reinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .$ _4 \" ?3 V# K3 E) }- L
HER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative
& [, l! @. h( ?! G0 O- q3 O5 Tclinicaltrials.
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