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Clinical Challenge: Optimal Therapies for Rare EGFR Mutations in NSCLC

*June 2021*

— Patients harboring these uncommon mutations may need “special selection of EGFR TKIs”

EGFR mutations in non-small cell lung cancer (NSCLC) were first pinpointed in 2004. These mighty mutations have emerged as the strongest predictor of response to EGFR tyrosine kinase inhibitor (TKI) therapies, with deletions in exon 19 and the point mutation L858R in exon 21 accounting for the vast majority of cases (about 85%).

However, roughly 15% of EGFR mutations are less common, including “point mutations, deletions and insertions within exons 18-25 of the EGFR gene,” such as exon 20 in-frame insertions, exon 20/T790M point mutations, exon 18/G719X point mutations, and others, explained Paul H. Huang, PhD, of the Institute of Cancer Research in London, and colleagues.

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