LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND
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J. Mazieres, S. Peters
6 V0 N* f3 a/ dIntroduction: 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( u% b6 f5 v& x5 i5 I# @
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 targeted8 Q9 z/ p# z2 J1 v! g( y8 z' f# D
treatment was delivered after convention al chemothe rapy. A total of 20 anti-Her2
7 \) D% _9 ?; w2 Ntreatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations$ i5 r( A) V* X3 H m% Z
and 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;
3 j7 s) T* Z w8 T* `* [9 Wdisease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for
$ _. ]* M( k8 r: Z0 H- V qtrastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to" }! Q- Z+ T) a( u# I. R, U; X
lapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and- r( J( D) _ Y4 e1 G u6 |$ V+ X
22.9 months for respectively early stage and stag e IV patients.
( E5 x! j) L# H. b" x0 w6 [( qConclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,5 n7 v: ~! T5 Z& }$ B
reinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .; ?$ w& `( V5 L! S+ Q8 d
HER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative
- `8 e6 Y4 y. U( Vclinicaltrials.
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