1232PD - Lung cancer harboring HER2 mutation: epidemiological characteristics and therapeutic perspectives

Date 30 September 2012
Event ESMO Congress 2012
Session NSCLC, metastatic
Topics Non-Small-Cell Lung Cancer, Metastatic
Cancer Aetiology, Epidemiology, Prevention
Pathology/Molecular Biology
Presenter Julien Mazières
Authors J. Mazières1, S. Peters2, A. Cortot3, B. Besse4, F. Barlesi5, M. Beau-Faller6, T. Urban7, D. Moro-Sibilot8, J. Milia1, O. Gautschi9
  • 1Department Of Pneumology, CHU Toulouse - Hôpital Larrey, 31400 - Toulouse/FR
  • 2Oncology, Centre Hospitalier Universitaire Vaudois - CHUV, CH-1011 - Lausanne/CH
  • 3Pneumology, CHU Lille, Lille/FR
  • 4Dept. Of Medicine, Institut Gustave Roussy, 94805 - Villejuif/FR
  • 5Service D'oncologie Multidisciplinaire Et Innovations Thérapeutique, Hôpital Nord, Marseille/FR
  • 6Hôpitaux Universitaires De Strasbourg Et Inserm U682 Hôpital De Hautepierre Laboratoire De Biochimie Et De Biologie Moléculaire 1, Av. Molière 67098 Strasbourg Cedex Tel : +33 3 88 12 71 79 E/m Laboratoire De Biochimie Et De Biologie Moléculaire, Hôpitaux Universitaires de Strasbourg et INSERM U682 Hôpital de Hautepierre, 67098 - strasbourg/FR
  • 7Oncology Department, CHU anger, anger/FR
  • 8Cancérologie, Hôpital A. Michallon - CHU Grenoble, Grenoble/FR
  • 9Klinik Für Onkologie, Luzerner Kantonsspital, CH-6004 - Luzern/CH

 

Abstract

Introduction

HER2 oncogene is a member of the EGFR family, encoding a transmembrane 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 clinicopathological characteristics and therapeutic outcomes of patients harboring HER2 mutation in a large European series.

Results

We retrospectively identified 46 NSCLC patients diagnosed with HER2 exon 20 mutation. HER2 mutation was mainly exclusive as only one concomitant KRas mutation was described. 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 adenocarcinomas (two with lepidic features). Half of the patients had stage IV disease at the time of diagnosis. HER2 targeted treatment was delivered after conventional chemotherapy. A total of 20 anti-Her2 treatments were evaluable. We observed 4 progressive diseases, 7 disease stabilizations and 9 partial responses according to RECIST 1.1 (overall response rate ORR = 45%; disease control rate DCR = 80%). Specifically, we observed a DCR of 92% for trastuzumab-based therapies (n = 14), 100 % for afatinib (n = 3) but no response to lapatinib (n = 2) and to a multiTKI (n = 1). Median survival was of 68.2 months and 22.9 months for respectively early stage and stage IV patients.

Conclusion

This study, the largest to date dedicated to HER2 mutated NSCLC, reinforces the importance of an HER2 screening strategy in lung adenocarcinomas. HER2-targeted drugs should be tested further, ideally within large collaborative clinical trials.

Disclosure

All authors have declared no conflicts of interest.