LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND. G5 T3 g# ~8 [! e1 t) b
THERAPE UTIC PERSPECTIVES
& c2 ~8 X5 l" f9 l; b2 bJ. Mazieres, S. Peters
( K$ ~) ]0 T5 Y) UIntroduction: 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
8 I2 T4 f3 Y1 j" |! s6 Zoutcomes 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 targeted4 a# a8 L' a) {; M0 I
treatment was delivered after convention al chemothe rapy. A total of 20 anti-Her2. l* E7 O# V1 j2 P
treatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations
' R" k$ i0 g) i, B$ eand 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;
6 Q. r' n% Y6 E6 I+ _' B6 gdisease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for
) ~7 ^5 ^2 d: Btrastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to
6 |8 a' ]$ i& M" G; H5 Z+ J3 Y0 n4 Qlapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and
9 U1 G# U$ L: a+ M22.9 months for respectively early stage and stag e IV patients./ m, I# p% Z# t
Conclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,
! P9 t& X& \$ |2 u7 Kreinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .4 Z' l3 y) G' x) l4 B; t4 r& E
HER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative) m* \5 L) w) y9 `+ Z* x
clinicaltrials.* s3 ~4 q3 [2 F+ a
|
显身卡
