LUNG CANCER HARB ORING HER2 MUTATION :EPIDE MIOLOGI CAL CHARACTE RISTICS AND
, x7 L$ n1 V' j( y+ I$ N# F, ZTHERAPE UTIC PERSPECTIVES5 F& C9 A; j0 v1 d) ?
J. Mazieres, S. Peters- H- k+ I; \4 X6 c$ J0 G
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, h7 a1 g" p2 B: [" S/ ^( D- o1 }
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
6 a5 g* [$ `6 S( |3 J# w% i' m) Xtreatment was delivered after convention al chemothe rapy. A total of 20 anti-Her2( Y5 R) q9 \1 o- O6 h/ _ r
treatments were eval uable. We observed 4 progressive dise ases, 7 disease stabilizations, T0 o' W& ?" z8 L. G8 k
and 9 partial resp onses according to RECIST 1.1 (overall response rate ORR = 45% ;
) ?* U: e- ]% Jdisease control rate DCR = 80%). Specifica lly, we obse rved a DCR of 92% for
g1 C1 {- W# Y" I8 b' P! E; {trastuzum ab-based therapie s (n = 14), 100 % for afatinib (n = 3) but no response to0 q5 t- M$ i/ E" Q3 @5 {
lapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and# I; I; g9 e8 ]7 ~- E
22.9 months for respectively early stage and stag e IV patients.
, n& |$ p( C1 ]* TConclusion: This study, the largest to date dedic ated to HER2 mutated NSCLC,
( V N/ h6 X. \# Q" z; D Freinforces the importance of an HER2 screening strategy in lung adenoc arcinomas .' C8 g6 p2 Q7 a; _ f+ V$ `
HER2-target ed drugs shou ld be tested further, ide ally withi n large collaborative2 l' r3 N/ b" E
clinicaltrials.7 W& K5 K M" d
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