Emerging therapies for non-small cell lung cancer harboring EGFR exon 20 insertion mutations: narrative review

Abstract

Background and Objective: Epidermal growth factor receptor (EGFR) exon 20 insertion mutations (ex20ins) are uncommon in non-small cell lung cancer (NSCLC). These mutations are generally resistant to first-generation EGFR tyrosine kinase inhibitors, unlike common EGFR mutations, including exon 19 deletions or exon 21 L858R point mutation. The development of effective targeted therapies for NSCLC harboring EGFR ex20ins has been eagerly anticipated over the years. Recently, the therapeutic landscape of this subgroup of EGFR-mutant NSCLC patients has rapidly evolved due to the emergence of new drugs.In 2021, several novel agents, such as amivantamab and mobocertinib, have been approved by the US Food and Drug Administration for patients with advanced platinum-resistant NSCLC harboring EGFR ex20ins.In this review, we mainly focus on emerging therapies targeting NSCLC with EGFR ex20ins, as well as important ongoing clinical trials.

Current status and breakthroughs in treating advanced non-small cell lung cancer with EGFR exon 20 insertion mutations

“…The efficacy of newly developed targeted drugs for this condition has been observed to a certain extent. Significant progress has been made recently, and the NCCN-recommended drugs, mobocertinib and amivantamab are at the forefront of targeted therapies for this patient population ( 120 ). The mechanisms of action and routes of administration of these two drugs are different, presenting additional treatment options for patients.…”