EGFR exon 20 insertion mutations in non-small cell lung cancer

doi:10.21037/tcr.2020.03.10

Review

. 2020 Apr;9(4):2982-2991.

doi: 10.21037/tcr.2020.03.10.

EGFR exon 20 insertion mutations in non-small cell lung cancer

Fenfang Wang^#^{1

2}, Chenghui Li^#^{3

4}, Qihuan Wu⁵, Hongyang Lu^{4

6}

Affiliations

¹ Department of Medical Oncology, Xiangshan First People's Hospital, Xiangshan 315700, China.
² Graduate School, Wenzhou Medical University, Wenzhou 325035, China.
³ The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310053, China.
⁴ Department of Thoracic Medical Oncology, Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou 310022, China.
⁵ Department of Medical Emergency, Xiangshan First People's Hospital, Xiangshan 315700, China.
⁶ Zhejiang Key Laboratory of Diagnosis and Treatment Technology on Thoracic Oncology (Lung and Esophagus), Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou 310022, China.

^# Contributed equally.

PMID: 35117654
PMCID: PMC8799012
DOI: 10.21037/tcr.2020.03.10

Review

EGFR exon 20 insertion mutations in non-small cell lung cancer

Fenfang Wang et al. Transl Cancer Res. 2020 Apr.

. 2020 Apr;9(4):2982-2991.

doi: 10.21037/tcr.2020.03.10.

Authors

Fenfang Wang^#^{1

2}, Chenghui Li^#^{3

4}, Qihuan Wu⁵, Hongyang Lu^{4

6}

Affiliations

¹ Department of Medical Oncology, Xiangshan First People's Hospital, Xiangshan 315700, China.
² Graduate School, Wenzhou Medical University, Wenzhou 325035, China.
³ The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310053, China.
⁴ Department of Thoracic Medical Oncology, Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou 310022, China.
⁵ Department of Medical Emergency, Xiangshan First People's Hospital, Xiangshan 315700, China.
⁶ Zhejiang Key Laboratory of Diagnosis and Treatment Technology on Thoracic Oncology (Lung and Esophagus), Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou 310022, China.

^# Contributed equally.

PMID: 35117654
PMCID: PMC8799012
DOI: 10.21037/tcr.2020.03.10

Abstract

Mutations in the epidermal growth factor receptor (EGFR) gene are the most common targetable genomic drivers of non-small cell lung cancer (NSCLC). 90% of the EGFR mutations comprise of EGFR exon 19 deletion and exon 21 L858R mutation, while EGFR exon 20 insertion (EGFR Ex20Ins) is the third most common type of EGFR mutation. Currently, studies on EGFR Ex20Ins are relatively scarce and limited. The frequency of EGFR Ex20Ins mutations in NSCLC was 1-10%. Patients harboring EGFR Ex20Ins exhibited similar clinical characteristics except for poorer prognosis as compared to patients with sensitizing mutations in EGFR. Conventional TKIs have poor efficacy in a majority of EGFR Ex20Ins subtypes. Chemotherapy remains the preferred treatment for advanced NSCLC patients harboring EGFR Ex20Ins. However, some novel inhibitors are considered as putative candidates. This review focuses on the structural and biochemical features, clinical characteristics, treatments, and prognosis of EGFR Ex20Ins in NSCLC.

Keywords: EGFR exon 20 insertion mutations; EGFR-TKIs; clinical features; non-small cell lung cancer (NSCLC); prognosis; structural features; treatment.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/tcr.2020.03.10). The authors have no conflicts of interest to declare.

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References

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[1] Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;68:394-424. 10.3322/caac.21492 - DOI - PubMed

[2] Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;68:394-424. 10.3322/caac.21492 - DOI - PubMed

[3] Passiglia F, Pilotto S, Facchinetti F, et al. Treatment. of advanced non-small-cell lung cancer: The 2019 AIOM (Italian Association of Medical Oncology) clinical practice guidelines. Crit Rev Oncol Hematol 2020;146:102858. 10.1016/j.critrevonc.2019.102858 - DOI - PubMed

[4] Passiglia F, Pilotto S, Facchinetti F, et al. Treatment. of advanced non-small-cell lung cancer: The 2019 AIOM (Italian Association of Medical Oncology) clinical practice guidelines. Crit Rev Oncol Hematol 2020;146:102858. 10.1016/j.critrevonc.2019.102858 - DOI - PubMed

[5] Osmani L, Askin F, Gabrielson E, et al. Current WHO guidelines and the critical role of immunohistochemical markers in the subclassification of non-small cell lung carcinoma (NSCLC): Moving from targeted therapy to immunotherapy. Semin Cancer Biol 2018;52:103-9. 10.1016/j.semcancer.2017.11.019 - DOI - PMC - PubMed

[6] Osmani L, Askin F, Gabrielson E, et al. Current WHO guidelines and the critical role of immunohistochemical markers in the subclassification of non-small cell lung carcinoma (NSCLC): Moving from targeted therapy to immunotherapy. Semin Cancer Biol 2018;52:103-9. 10.1016/j.semcancer.2017.11.019 - DOI - PMC - PubMed

[7] 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;9:4181-86. 10.2147/OTT.S108242 - DOI - PMC - PubMed

[8] 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;9:4181-86. 10.2147/OTT.S108242 - DOI - PMC - PubMed

[9] Yasuda H, Kobayashi S, Costa DB. EGFR exon 20 insertion mutations in non-small -cell lung cancer: preclinical data and clinical implications. Lancet Oncol 2012;13:e23-31. 10.1016/S1470-2045(11)70129-2 - DOI - PubMed

[10] Yasuda H, Kobayashi S, Costa DB. EGFR exon 20 insertion mutations in non-small -cell lung cancer: preclinical data and clinical implications. Lancet Oncol 2012;13:e23-31. 10.1016/S1470-2045(11)70129-2 - DOI - PubMed

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EGFR exon 20 insertion mutations in non-small cell lung cancer

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EGFR exon 20 insertion mutations in non-small cell lung cancer

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