Targeted therapy of non-small cell lung cancer with rare EGFR gene mutations

June 25, 2021
817
Resume

The treatment of choice for patients with EGFR mutation-positive non-small cell lung cancer (NSCLC) is an EGFR tyrosine kinase inhibitor (TKI). Most clinical trial data with these agents are limited to patients with the common activating EGFR mutations as follows: exon 19 deletions and exon 21 L858R point mutations. However, a significant proportion of patients with NSCLC harbor uncommon EGFR mutations that have variable sensitivity to different EGFR TKIs. Owing to its molecular structures, osimertinib has broader inhibitory profiles than the first-generation agents. Nevertheless, the paucity of prospective clinical data, the wide heterogeneity of uncommon mutations, and the existence of compound mutations often complicate treatment decisions in this patient subgroup. The following we collate clinical data on the efficacy of third generation TKIs, in particular osimertinib, in patients with NSCLC and rare or complex EGFR mutations. Particular attention is paid to the treatment of this subgroup of patients in the active phase of the COVID-19 disease, including the results of our own observations.

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