Treatment outcome of atypical EGFR mutations in the German National Network Genomic Medicine Lung Cancer (nNGM)

• The EGFR-TKI efficacy of uncommon EGFR mutations generally considered TKI-sensitive was validated.
• Complex EGFR mutations containing exon19del or L858R mutations were EGFR TKI sensitive, independent of the combination partner.
• Very rare single and complex mutations, comprising 40% of atypical mutations, show a high heterogeneity of TKI sensitivity.
• TP53 co-mutations may confer a detrimental outcome in TKI treated patients with very rare EGFR mutations and exon20ins.
• We propose a novel nNGM classification for rare EGFR mutations.

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