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Updated: Feb 9, 2026

Detection of Targetable Alterations in Non-small Cell Lung Cancer using Next-generation Sequencing
Published on: October 10, 2025
Case Report: Osimertinib achieved remarkable and sustained disease control in an advanced non-small-cell lung cancer
Minglei Yang1, Xiaoling Tong2, Xiang Xu1
1Department of Cardiothoracic Surgery, Ningbo No. 2 Hospital, Ningbo, Zhejiang, 315012, China.
Abstract:
Missense mutations in EGFR exon 20 are rare in non-small-cell lung cancer (NSCLC), and mostly insensitive to the first generation tyrosine kinase inhibitors (TKIs) of EGFR. However, their responses to the third generation TKI are unclear. Here, we reported a patient with advanced NSCLC harboring a rare EGFR H773L/V774M mutation complex. Although he was irresponsive to the first generation TKI gefitinib, he demonstrated sustained disease control to osimertinib, suggesting that this complex is an activating mutation of EGFR and can be suppressed by osimertinib. The follow-up genetic profiling revealed multiple acquired new mutations that might be related to his resistance to osimertinib. This finding would provide valuable experience for future treatment of the same mutations.
Insights
Rare EGFR exon 20 mutations in non-small-cell lung cancer (NSCLC) can be treated with third-generation tyrosine kinase inhibitors (TKIs). A patient with a complex EGFR mutation showed sustained disease control with osimertinib, offering insights for future treatments.
Area of Science:
- Oncology
- Molecular Biology
- Genetics
Background:
- Missense mutations in EGFR exon 20 are uncommon in NSCLC.
- These mutations often confer resistance to first-generation EGFR TKIs.
- The efficacy of third-generation TKIs against these rare mutations remains largely unknown.
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