LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND# g [3 [. W) ?3 L' @5 ~* W; W
THERAPE UTIC PERSPECTIVES
& q4 N. [, `$ v. M2 SJ. Mazieres, S. Peters
& T2 I( e8 e' g: S) W( @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
. ]( y# g9 O$ N% R& }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
7 B+ s0 C' n/ I, ~treatment was delivered after convention al chemothe rapy. A total of 20 anti-Her2
" O6 _- X! P0 Y$ _3 ztreatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations# \- [; c6 P7 t! E+ z; L
and 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;; s; s6 R- T: S; ]
disease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for
# s5 ~% {# C( C2 L/ ~1 o: ^trastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to9 H r: ~8 j: [3 P1 b
lapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and
% O7 O- X7 z$ w6 a2 @7 y2 V22.9 months for respectively early stage and stag e IV patients.! R! H# y& u, x2 ]7 M0 s n5 y9 n
Conclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,! s4 A6 S' o6 O& S$ {
reinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .# G6 r" c" {( i3 D- s* B
HER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative
' }% F+ q! \8 kclinicaltrials.
3 U7 x" ?9 M: V+ C4 l& p |
显身卡
