EGFR EXON 20 INSERTION MUTATIONS ARE THE 3RD MOST PREVALENT PRIMARY EGFR MUTATION, YET THEY ARE OFTEN UNDETECTED4
Current biomarker testing practices can make it difficult to identify these patients4,5,7,11
PCR-based tests, which are mutation-specific, have technical limitations and can only detect a limited number of exon 20 insertion mutations4,7,11
Exon 20 insertion mutations cannot be treated effectively with current targeted therapies. Therefore, they are not given prominence on the NGS report1,3,5-9
Through the use of testing techniques that detect a broader range of mutations—either liquid or tissue NGS—and careful examination of biomarker test results, you can better understand the full picture of treatment options for your patients with EGFR-positive mNSCLC.4,11,12
NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) strongly advise broader molecular profiling in eligible patients with mNSCLC, with the goal of identifying rare driver mutations.13*†
BUT ACCURATE DETECTION IS ONLY THE FIRST STEP IN FIGHTING THIS MUTATION
CURRENT TKI THERAPIES ARE NOT EFFECTIVE AT TREATING PATIENTS WITH EXON 20 INSERTION MUTATIONS, MAKING THEM MORE DIFFICULT TO TREAT THAN CLASSICAL EGFR MUTATIONS3,6-9
Exon 20 insertion mutations are intrinsically resistant to EGFR TKIs, unlike common sensitizing mutations (eg, L858R and exon 19 deletions) or EGFR exon 20 T790M mutations.3,6-9
Response to TKIs in treatment-naive patients:
EGFR exon 20 insertion mutations14,15
EGFR exon 20 insertion mutations10
Classical EGFR exon 19 deletion or L858R mutation16
‡Results from a real-world analysis of treatment patterns (95% confidence interval [CI], 2.8-19.4).10
§The median overall survival was 38.6 months (95% CI, 34.5 to 41.8) in the osimertinib group and 31.8 months (95% CI, 26.6 to 36.0) in the comparator group (hazard ratio for death, 0.80; 95.05% CI, 0.64 to 1.00; P=0.046).16
The NCCN Guidelines® recommend treating patients without a sensitizing EGFR mutation, like patients with most exon 20 insertion mutations, with a systemic therapy, like platinum-based chemotherapy.13¶
Progression-free survival in treatment-naive patients with exon 20 insertion mutations:
Platinum-based chemotherapy17-19
TKIs3||
||TKIs included in this analysis were erlotinib, gefitinib, and afatinib.3
DON’T LET THIS MUTATION GET BY YOU. TEST FOR, FIND, AND APPROPRIATELY MANAGE EXON 20 INSERTION MUTATIONS.
YOUR PATIENTS’ LIVES DEPEND ON IT