LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND
. E# @3 Z i& D8 M0 h* P L, ]* hTHERAPE UTIC PERSPECTIVES0 y1 |9 U( A V1 H' k
J. Mazieres, S. Peters
* {( J6 n3 L4 @5 EIntroduction: 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
5 [& s( j( Z* c, D! G8 boutcomes 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 U+ d; a" w- U# Atreatment was delivered after convention al chemothe rapy. A total of 20 anti-Her2. o! J3 l. z7 b( o
treatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations8 F1 F; I' @. O4 P! G8 Z5 T, w
and 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;
/ s. j8 `3 [2 \9 E ]disease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for+ v6 ^" ?8 x }: h. r' c4 J
trastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to
- v/ i9 W2 ?9 ?: ]$ ?% f. xlapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and( n( _ P# @% I2 T7 U7 ?
22.9 months for respectively early stage and stag e IV patients.8 o* N& ]1 e% w- o
Conclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,9 `# ^' I6 d7 {& E1 |
reinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .* e. k Y# X6 j1 V/ V, G
HER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative
# a3 A" r* H% h, Cclinicaltrials. [" E7 c5 Y; b7 M8 [' d) n, n5 n
|
显身卡
