1,374
Views
13
CrossRef citations to date
0
Altmetric
Revolutionary Victories in Cancer Care

Non-small cell lung cancer with EGFR exon 20 insertion mutation: a systematic literature review and meta-analysis of patient outcomes

, ORCID Icon, , , , ORCID Icon, & show all
Pages 1341-1350 | Received 21 Mar 2022, Accepted 24 May 2022, Published online: 20 Jun 2022

References

  • Carper MB, Claudio PP. Clinical potential of gene mutations in lung cancer. Clin Transl Med. 2015;4(1):33.
  • Midha A, Dearden S, McCormack R. EGFR mutation incidence in non-small-cell lung cancer of adenocarcinoma histology: a systematic review and global map by ethnicity (mutMapII). Am J Cancer Res. 2015;5(9):2892–2911.
  • Rosell R, Moran T, Queralt C, et al. Screening for epidermal growth factor receptor mutations in lung cancer. N Engl J Med. 2009;361(10):958–967.
  • Burnett H, Emich H, Carroll C, et al. Epidemiological and clinical burden of EGFR exon 20 insertion in advanced non-small cell lung cancer: a systematic literature review. PLoS One. 2021;16(3):e0247620.
  • Vyse S, Huang PH. Targeting EGFR exon 20 insertion mutations in non-small cell lung cancer. Signal Transduct Target Ther. 2019;4:5.
  • Oxnard GR, Lo PC, Nishino M, et al. Natural history and molecular characteristics of lung cancers harboring EGFR exon 20 insertions. J Thorac Oncol. 2013;8(2):179–184.
  • NICE. Alogithm for systemic treatment options for advanced non-squamous NSCLC:EGFR-TK, ALK or ROS-1 positive. 2021. 2053-6178. https://www.nice.org.uk/guidance/ng122/resources.
  • European Society for Medical Oncology. Metastatic non-small cell lung cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Updated version 15 September 2020. 2020.
  • Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Non-Small Cell Lung Cancer V3.2022 © National Comprehensive Cancer Network, Inc. 2022. All rights reserved. 2022; [cited 2020 Mar 17]. To view the most recent and complete version of the guideline, go online to NCCN.org. NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way.
  • Hanna NH, Robinson AG, Temin S, et al. Therapy for stage IV non-small-cell lung cancer with driver alterations: ASCO and OH (CCO) joint guideline update. J Clin Oncol. 2021;39(9):1040–1091.
  • Robichaux JP, Le X, Vijayan RSK, et al. Structure-based classification predicts drug response in EGFR-mutant NSCLC. Nature. 2021;597(7878):732–737.
  • Yasuda H, Park E, Yun CH, et al. Structural, biochemical, and clinical characterization of epidermal growth factor receptor (EGFR) exon 20 insertion mutations in lung cancer. Sci Transl Med. 2013;5(216):216ra177.
  • Takeda Pharmaceuticals America Inc. EXKIVITY™ (mobocertinib) capsules, for oral use. Prescribing Information. 2021. https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/215310s000lbl.pdf.
  • Janssen Pharmaceutical Companies. RYBREVANT (amivantamab-vmjw) injection, for intravenous use Prescribing Information. 2021. https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/761210s000lbl.pdf.
  • The Cochrane Collaboration. Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1.0 [updated March 2011]. 2011.
  • Centre for Reviews and Dissemination. Systematic Reviews: CRD’s guidance for undertaking reviews in health care. 2009. https://www.york.ac.uk/media/crd/Systematic_Reviews.pdf.
  • Ades AE, Caldwell DM, Reken S, et al. NICE DSU Technical Support Document 7: evidence synthesis of treatment efficacy in decision making: A Reviewer’s Checklist. 2012. www.nicedsu.org.uk.
  • Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151(4):264–269.
  • McGrath S, Zhao X, Qin ZZ, et al. One-sample aggregate data meta-analysis of medians. Stat Med. 2019;38(6):969–984.
  • The Cochrane Collaboration. Cochrane handbook for systematic reviews of interventions. Version 5.1.0; [updated March 2011, cited 2022 Jan 13]. Available from: https://handbook-5-1.cochrane.org/chapter_10/10_4_3_1_recommendations_on_testing_for_funnel_plot_asymmetry.htm.
  • Miura S. P50.03 – A Real-World Cohort Study of EGFR TKIs in Patients with NSCLCwith Uncommon EGFR mutations (UpSwinG) (Abstract). IASLC: 2021 World Conference on Lung Cancer. 2021.
  • Miura S, Hsia T-C, Hung J-Y, et al. 145P UpSwinG: real-world, non-interventional cohort study on TKI activity in patients (pts) with EGFR mutation-positive (EGFRm+) NSCLC with uncommon mutations. J Thoracic Oncol. 2021;16(4):S776–S777.
  • Ou S, Lin H, Hong J, et al. Real-world response and outcomes in NSCLC patients with EGFR exon 20 insertionmutations. Am Soc Clin Oncol. 2021;39(15):9098–9098.
  • Dersarkissian M, Bhak R, Lin H, et al. P2.01-103 real-world treatment patterns and survival in non-small cell lung cancer patients with EGFR exon 20 insertion mutations. J Thoracic Oncol. 2019;14(10):S681.
  • Minchom AR, Girard N, Bazhenova L, et al. Amivantamab compared with real-world therapies in patients with NSCLC with EGFR Exon 20 insertion mutations who have progressed after platinum doublet chemotherapy. J Clin Oncol. 2021;39(15_suppl):9052–9052.
  • Choudhury NJ, Schoenfeld AJ, Flynn J, et al. Response to standard therapies and comprehensive genomic analysis for patients with lung adenocarcinoma with EGFR Exon 20 insertions. Clin Cancer Res. 2021;27(10):2920–2927.
  • Lo PC, Jackman DM, Butaney M, et al. Clinical behavior of lung cancers harboring EGFR Exon 20 insertions. J Thoracic Oncol. 2012;7(9)(4):S206–S207.
  • Hastings K, Yu HA, Wei W, et al. EGFR mutation subtypes and response to immune checkpoint blockade treatment in non-small-cell lung cancer. Ann Oncol. 2019;30(8):1311–1320.
  • Bravo Montenegro G, Vanderwalde A, Raez L, et al. P76.43 Co-occurring genomic alterations and treatment outcomes in patients with EGFR exon 20 insertion positive NSCLC. J Thoracic Oncol. 2021;16(3):S605–S606.
  • Beau-Faller M, Prim N, Ruppert AM, et al. Rare EGFR exon 18 and exon 20 mutations in non-small-cell lung cancer on 10 117 patients: a multicentre observational study by the French ERMETIC-IFCT network. Ann Oncol. 2014;25(1):126–131.
  • Yang G, Li J, Xu H, et al. EGFR exon 20 insertion mutations in Chinese advanced non-small cell lung cancer patients: molecular heterogeneity and treatment outcome from nationwide real-world study. Lung Cancer. 2020;145:186–194.
  • Xu CW, Wang WX, Wang D, et al. Pemetrexed-based chemotherapy for non-small-cell lung cancer patients with EGFR exon 20 insertion mutation: a multicenter study. Transl Lung Cancer Res. 2020;9(5):1853–1861.
  • Qin Y, Jian H, Tong X, et al. Variability of EGFR exon 20 insertions in 24 468 Chinese lung cancer patients and their divergent responses to EGFR inhibitors. Mol Oncol. 2020;14(8):1695–1704.
  • Yang GJ, Li J, Xu HY, et al. Osimertinib for Chinese advanced non-small cell lung cancer patients harboring diverse EGFR exon 20 insertion mutations. Lung Cancer. 2021;152:39–48.
  • Wang Y, Li J, Zhou Y, et al. Tumor genomics and response to chemotherapy in advanced non-small cell lung cancer with exon 20 insertion epidermal growth factor receptor mutations. Ann Transl Med. 2020;8(20):1297.
  • Zhao C, Li X, Su C, et al. P1.01-111 EGFR exon20 insertion patients treated with First-Line chemotherapy in non-small cell lung cancer. J Thoracic Oncol. 2018;13(10):S507.
  • Chen D, Song Z, Cheng G. Clinical efficacy of first-generation EGFR-TKIs in patients with advanced non-small-cell lung cancer harboring EGFR exon 20 mutations. Onco Targets Ther. 2016;9:4181–4186.
  • Udagawa H, Matsumoto S, Ohe Y, et al. OA07.03 clinical outcome of non-small cell lung cancer with EGFR/HER2 exon 20 insertions identified in the LC-SCRUM-Japan. J Thoracic Oncol. 2019;14(10):S224.
  • Wu JY, Yu CJ, Shih JY. Effectiveness of treatments for advanced non-small-cell lung cancer with exon 20 insertion epidermal growth factor receptor mutations. Clin Lung Cancer. 2019;20(6):e620–e630.
  • Ovcaricek T, Unk M, Kern I, et al. 173PD. EGFR exon 20 insertion mutations in NSCLC: frequency and treatment outcomes with EGFR directed TKIs. J Thoracic Oncol. 2012;7(6):S7–S89.
  • Cardona AF, Rojas L, Zatarain-Barron ZL, CLICaP, et al. EGFR exon 20 insertion in lung adenocarcinomas among Hispanics (geno1.2-CLICaP). Lung Cancer. 2018;125:265–272.
  • Christopoulos P, Grohe C, Griesinger F, et al. Real-world study of NSCLC with EGFR exon 20 insertions. J Thoracic Oncol. 2021;16(4):S780–S781.
  • Udagawa H, Matsumoto S, Ohe Y, et al. Clinical outcome of non-small cell lung cancer with EGFR/HER2 exon 20 insertions identified in the LC-SCRUM-Japan (poster). presented at: 2019. World Conference on Lung Cancer 2019; Barcelona, Spain.
  • Riely GJ, Neal JW, Camidge DR, et al. Activity and safety of mobocertinib (TAK-788) in previously treated Non-Small cell lung cancer with EGFR exon 20 insertion mutations from a phase I/II trial. Cancer Discov. 2021;11(7):1688–1699.
  • Zhou C, Ramalingam SS, Kim TM, et al. Treatment outcomes and safety of mobocertinib in platinum-pretreated patients with EGFR exon 20 insertion-positive metastatic non-small cell lung cancer: a phase 1/2 open-label nonrandomized clinical trial. JAMA Oncol. 2021;7(12):e214761.
  • Zhou C. Mobocertinibin NSCLC With EGFRExon 20 Insertions: results from EXCLAIM and platinum-pretreated patient populations (poster). IASLC: 2020 World Conference on Lung Cancer. 2020.
  • Ramalingam S, Zhou C, Kim TM, et al. Mobocertinib (TAK-788) in EGFR exon 20 insertion + metastatic NSCLC: additional results from platinum-pretreated patients and EXCLAIM cohort of phase 1/2 study (poster). 2021.
  • Spira A, Ramalingam S, Neal J, et al. Mobocertinib in EGFR exon 20 insertion–positive metastatic NSCLC patients with disease control on prior EGFR TKI therapy (poster). IASLC: 2021 World Conference on Lung Cancer. 2021.
  • Park K, Haura EB, Leighl NB, et al. Amivantamab in EGFR Exon 20 insertion-mutated non-small-cell lung cancer progressing on platinum chemotherapy: initial results from the CHRYSALIS phase I study. J Clin Oncol. 2021;39(30):3391–3402.
  • Nagasaka M, Goto K, Gomez JE, et al. Amivantamab in combination with chemotherapy in patients with advanced non-small cell lung cancer (NSCLC) (poster). IASLC: 2021 World Conference on Lung Cancer. 2021.
  • Cornelissen R, Garassino MC, Le X, et al. MA11.04 updated efficacy, safety and dosing management of poziotinib in previously treated EGFR and HER2 exon 20 NSCLC patients. J Thoracic Oncol. 2021;16(3):S173–S174.
  • Le X, Goldman JW, Clarke JM, et al. Poziotinib shows activity and durability of responses in subgroups of previously treated EGFR exon 20 NSCLC patients. J Clin Oncol. 2020;38(15_suppl):9514–9514.
  • Le X, Goldman J, Clarke J, et al. Abstract CT081: Poziotinib activity and durability of responses in previously treated EGFR exon 20 NSCLC patients – a Phase 2 study. presented at: Tumor Biology; 2020.
  • Sacher A, Le X, Cornelissen R, et al. 36MO safety, tolerability and preliminary efficacy of poziotinib with twice daily strategy in EGFR/HER2 Exon 20 mutant non-small cell lung cancer. Annals of Oncology. 2021;2021:32.
  • Piotrowska Z, Costa DB, Oxnard GR, et al. Activity of the Hsp90 inhibitor luminespib among non-small-cell lung cancers harboring EGFR exon 20 insertions. Ann Oncol. 2018;29(10):2092–2097.
  • Piotrowska Z, Smit EF, Costa D. MINI30.06 activity of AUY922 in NSCLC patients with EGFR Exon 20 insertions. J Thoracic Oncol. 2015;10(9):S261–S406.
  • Liu SV, Villaruz LC, Lee VHF, et al. LBA61 first analysis of RAIN-701: study of tarloxotinib in patients with non-small cell lung cancer (NSCLC) EGFR Exon 20 insertion, HER2-activating mutations & other solid tumours with NRG1/ERBB gene fusions. Annals Oncol. 2020;2020:31.
  • Piotrowska Z, Yu HA, Yang CH, et al. Abstract 9077: safety and activity of CLN-081 (TAS6417) in NSCLC with EGFR Exon 20 insertion mutations (Ins20) (poster). 2021.
  • Han BH, Zhou C, Wu JY, et al. Preclinical and preliminary clinical investigations of furmonertinibin NSCLC with EGFR exon 20 insertions (20ins) (poster). ESMO Congress 2021. 2021.
  • Janne PA, Wang M, Paul M, et al. Phase 1 studies of DZD9008, an oral, selective EGFR/HER2 inhibitor in advanced NSCLC with EGFRExon20 insertion mutation (poster). IASLC: 2021 World Conference on Lung Cancer. 2021.
  • Gao G, Wang Y, Ren S, et al. P83.03 efficacy of camrelizumab (SHR-1210) Plus apatinib in advanced NSCLC with EGFR mutation. J Thoracic Oncol. 2021;16(3):S654.
  • van Veggal B, van der Wekken AJ, Paats MS, et al. Interim results of a phase II single arm trial combining afatinib with cetuximab inpatients with EGFRex20ins positive NSCLC. Am Soc Clin Oncol. 2021;39:15.
  • Riess JW, Reckamp KL, Frankel P, et al. Erlotinib and onalespib lactate focused on EGFR exon 20 insertion Non-Small cell lung cancer (NSCLC): a California cancer consortium phase I/II trial (NCI 9878). Clin Lung Cancer. 2021;22(6):541–548.
  • Riess JW, Groshen SG, Reckamp KL, et al. Osimertinib (Osi) plus necitumumab (Neci) in EGFR-mutant NSCLC: an ETCTN California cancer consortium phase I study (abstract). American Society of Clinical Oncology. 2019. Available from: https://meetinglibrary.asco.org/record/174600/abstract
  • Zwierenga F, van Veggel BAMH, Hendriks LEL, et al. High dose osimertinib in patients with advanced stage EGFR exon 20 mutation-positive NSCLC: results from a phase 2 multicenter study, POSITION20. ESMO Congress 2021. 2021. Abstract 1214P
  • Piotrowska Z, Wang Y, Sequist LV, et al. ECOG-ACRIN 5162: a phase II study of osimertinib 160 mg in NSCLC with EGFRexon 20 insertions. American Society of Clinical Oncology. 2020. https://meetinglibrary.asco.org/record/184821/abstract.
  • Kim TM, Ock CY, Kim M, et al. Phase II study of osimertinib in NSCLC patients with EGFR exon 20 insertion mutation: a multicenter trial of the Korean Cancer study group (LU17-19). Ann Oncol. 2019;2019:30.
  • Yang JCH, Sequist LV, Geater SL, et al. Clinical activity of afatinib in patients with advanced non-small-cell lung cancer harbouring uncommon EGFR mutations: a combined post-hoc analysis of LUX-Lung 2, LUX-Lung 3, and LUX-Lung 6. Lancet Oncol. 2015;16(7):830–838.
  • Shih J, Yu C, Su W. Activity of BIBW 2992, an irreversible EGFR/HER1 and HER2 TKI, in lung adenocarcinoma patients harboring less common EGFR mutations: 415P. Ann Oncol. 2010;21(8):viii122–viii161.
  • Yang JC, Shih J-Y, Su WC, et al. Afatinib for patients with lung adenocarcinoma and epidermal growth factor receptor mutations (LUX-Lung 2): a phase 2 trial. Lancet Oncol. 2012;13(5):539–548.
  • Yang J, Schuler M, Yamamoto N, et al. Activity of Afatinib in uncommon epidermal growth factor receptor (Egfr) mutations in lux-lung 3, a phase III trial of Afatinib or cisplatin/pemetrexed in EGFR mutation-positive lung cancer. Abstract number 2123. Ann Oncol. 2012;23(9):IX410–IX411.
  • Janning M, Suptitz J, Albers-Leischner C, et al. Treatment outcome of atypical EGFR mutations in the german national network genomic medicine lung cancer (nNGM). Ann Oncol. 2022;2022:S0923-7534(22)00361-1.
  • Kobayashi Y, Mitsudomi T. Not all epidermal growth factor receptor mutations in lung cancer are created equal: perspectives for individualized treatment strategy. Cancer Sci. 2016;107(9):1179–1186.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.