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Ref Type Journal Article
PMID (23610105)
Authors Mazières J, Peters S, Lepage B, Cortot AB, Barlesi F, Beau-Faller M, Besse B, Blons H, Mansuet-Lupo A, Urban T, Moro-Sibilot D, Dansin E, Chouaid C, Wislez M, Diebold J, Felip E, Rouquette I, Milia JD, Gautschi O
Title Lung cancer that harbors an HER2 mutation: epidemiologic characteristics and therapeutic perspectives.
Journal Journal of clinical oncology : official journal of the American Society of Clinical Oncology
Vol 31
Issue 16
Date 2013 Jun 01
URL
Abstract Text HER2 mutations are identified in approximately 2%of non-small-cell lung cancers (NSCLC). There are few data available that describe the clinical course of patients with HER2-mutated NSCLC.We retrospectively identified 65 NSCLC, diagnosed with a HER2 in-frame insertion in exon 20. We collected clinicopathologic characteristics, patients' outcomes, and treatments.HER2 mutation was identified in 65 (1.7%) of 3,800 patients tested and was almost an exclusive driver, except for one single case with a concomitant KRAS mutation. Our population presented with a median age of 60 years (range, 31 to 86 years), a high proportion of women (45 women v 20 men; 69%), and a high proportion of never-smokers (n= 34; 52.3%). All tumors were adenocarcinomas and 50% were stage IV at diagnosis. For these latter cases, 22 anti-human epidermal growth factor receptor 2 (HER2) treatments were administered after conventional chemotherapy in 16 patients. Subsequently, four patients experienced progressive disease, seven experienced disease stabilizations, and 11 experienced partial responses (overall response rate, 50%; disease control rate [DCR], 82%). Specifically, we observed a DCR of 93% for trastuzumab-based therapies (n = 15) and a DCR of 100% for afatinib (n = 3) but no response to other HER2-targeted drugs (n = 3). Progression-free survival for patients with HER2 therapies was 5.1 months. Median survival was of 89.6 and 22.9 months for early-stage and stage IV patients, respectively.This study, the largest to date dedicated to HER2-mutated NSCLC, reinforces the importance of screening for HER2 mutations in lung adenocarcinomas and suggests the potential efficacy of HER2-targeted drugs in this population.

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Molecular Profile Treatment Approach
Gene Name Source Synonyms Protein Domains Gene Description Gene Role
Therapy Name Drugs Efficacy Evidence Clinical Trials
Drug Name Trade Name Synonyms Drug Classes Drug Description
Gene Variant Impact Protein Effect Variant Description Associated with drug Resistance
Molecular Profile Indication/Tumor Type Response Type Therapy Name Approval Status Evidence Type Efficacy Evidence References
ERBB2 exon 20 ins lung non-small cell carcinoma predicted - sensitive Docetaxel + Trastuzumab Case Reports/Case Series Actionable In a clinical study, treatment with the combination of Herceptin (trastuzumab) and Taxotere (docetaxel) in a non-small cell lung cancer patient harboring an ERBB2 exon 20 insertion resulted in a partial response (PMID: 23610105). 23610105
ERBB2 exon 20 ins lung non-small cell carcinoma predicted - sensitive Trastuzumab Case Reports/Case Series Actionable In a clinical study, Herceptin (trastuzumab) treatment in a non-small cell lung cancer patient harboring an ERBB2 exon 20 insertion resulted in a partial response (PMID: 23610105). 23610105
ERBB2 exon 20 ins lung non-small cell carcinoma predicted - sensitive Carboplatin + Paclitaxel + Trastuzumab Case Reports/Case Series Actionable In a clinical study, treatment with the combination of Herceptin (trastuzumab), Paraplatin (carboplatin), and Taxol (paclitaxel) in non-small cell lung cancer patients harboring an ERBB2 exon 20 insertion (n=2) resulted in a partial response in one patient and stable disease in the other patient (PMID: 23610105). 23610105
ERBB2 exon 20 ins lung non-small cell carcinoma predicted - sensitive Trastuzumab + Vinorelbine Case Reports/Case Series Actionable In a clinical study, treatment with the combination of Herceptin (trastuzumab) and Navelbine (vinorelbine) in non-small cell lung cancer patients harboring an ERBB2 exon 20 insertion (n=8) resulted in a partial response in 5 patients and stable disease in 2 patients (PMID: 23610105). 23610105