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EGFR exon 20 insertion mutations and response to osimertinib in non-small-cell lung cancer

Wenfeng Fang1, Yihua Huang2, Shaodong Hong2

  • 1Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, People's Republic of China. fangwf@sysucc.org.cn.

BMC Cancer
|June 19, 2019
PubMed
Abstract

Insights

Osimertinib shows promising antitumor activity in advanced non-small cell lung cancer (NSCLC) patients with Epidermal Growth Factor Receptor exon 20 insertion (EGFRex20ins) mutations. This EGFRex20ins NSCLC treatment warrants further investigation.

Area of Science:

  • Oncology
  • Genetics
  • Pharmacology

Background:

  • Epidermal growth factor receptor exon 20 insertion (EGFRex20ins) mutations are found in 4-12% of EGFR mutations in non-small cell lung cancer (NSCLC).
  • EGFRex20ins mutations are typically resistant to first- and second-generation EGFR tyrosine kinase inhibitors (TKIs).
  • Effective therapies for EGFRex20ins NSCLC are needed.

Purpose of the Study:

  • To analyze the frequency and genetic characteristics of EGFRex20ins mutations in Chinese NSCLC patients.
  • To evaluate the antitumor activity and safety of osimertinib in NSCLC patients with EGFRex20ins mutations.

Main Methods:

  • Targeted next-generation sequencing (NGS) was used for tumor genotyping in 2316 Chinese NSCLC cases.
  • EGFR exon sequencing was performed to identify mutations.
  • Six patients with EGFRex20ins mutations receiving osimertinib were retrospectively analyzed for efficacy and safety.

Main Results:

  • EGFRex20ins mutations were identified in 2.3% of all NSCLC cases, with A767_V769dup being the most common.
  • Genetic characteristics of EGFRex20ins mutations in Chinese patients were similar to those in Caucasian patients.
  • Four of six patients achieved partial response, and two had stable disease, with a median progression-free survival of 6.2 months. No severe adverse events were observed.

Conclusions:

  • EGFRex20ins mutations in Chinese NSCLC patients share similar genetic characteristics with Caucasian populations.
  • Osimertinib demonstrated promising antitumor activity and a favorable safety profile in advanced EGFRex20ins NSCLC patients.
  • Further clinical studies are warranted to explore osimertinib as a treatment for EGFRex20ins NSCLC.
Keywords:
EGFRex20insNGSNSCLCOsimertinib

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