^
Association details:
Biomarker:EGFR exon 20 insertion
Cancer:Non Small Cell Lung Cancer
Drug Class:Immunotherapy
Direction:Sensitive
Evidence:
Evidence Level:
Sensitive: C3 – Early Trials
Title:

Comparative Clinical Outcomes Between EGFR Ex20ins and Wildtype NSCLC Treated with Immune Checkpoint Inhibitors

Published date:
07/20/2022
Excerpt:
CONTRADICTING EVIDENCE: A real-world, retrospective study was conducted to compare outcomes of ICI-treated patients with EGFR ex20ins and wildtype NSCLC….Patients with EGFR ex20ins had a 58% increased risk of shorter time to next-line therapy compared with wt-NSCLC (adjusted hazard ratio of 1.58 [95% confidence interval [CI], 1.2-2.1]; P = .0012). The median rwTTNT for first ICI line was 3.7 months (95% CI, 3.0-4.9) for EGFR ex20ins NSCLC compared with 5.8 months (95% CI, 5.6-6.0) for wt-NSCLC....ICI therapy may be less effective for patients with EGFR ex20ins compared with wt-NSCLC...tumors harboring ex20ins appear to be less responsive to immune checkpoint inhibition than wt-NSCLC.
DOI:
https://doi.org/10.1016/j.cllc.2022.07.007
Evidence Level:
Sensitive: C3 – Early Trials
Title:

Efficacy of ICIs on patients with oncogene-driven non-small cell lung cancer: a retrospective study

Published date:
01/04/2022
Excerpt:
The ORR and PFS were 16.7% (n = 12) and 28.6% (n = 7), 7.8 months and 9.0 months for HER2 and EGFR Exon20 insertion patients, respectively....ICI-based combination therapy could be considered for patients with ROS1 rearrangement, HER2 mutation and EGFR Exon20 insertion NSCLC....In total, 309 non-squamous NSCLC patients with a median age of 61 years (range 20-88 years) including 70.9% male were retrospectively enrolled….ICI combined therapy was significantly correlated with a longer PFS compared with ICI monotherapy (median PFS: 7.7 months vs. 4.7 months; P = 0.0112) [Figure 4C]. PFS was 5.5 months in L858R, 5.9 months in 19del, and 9.0 months in Exon20 insertion and other mutations....ICI-based combination therapy can bring benefit to patients with EGFR-mutant NSCLC.
Secondary therapy:
Chemotherapy
DOI:
10.20517/cdr.2021.85
Evidence Level:
Sensitive: C3 – Early Trials
Source:
Title:

1224P-Systematic review and meta-analysis of immunotherapy effectiveness for pretreated patients with non-small cell lung cancer harboring EGFR exon 20 insertions

Published date:
09/13/2021
Excerpt:
CONTRADICTING EVIDENCE: Across sources (N=91), reported ORRs ranged from 0% to 14.3% (1/7 patients in single study), with 2 total responses; DCRs ranged from 23.8% to 30.0%, and median PFS ranged from 2.3 months to 4.0 months….Results of this meta-analysis suggest that IO monotherapies are not effective in the ≥2nd-line setting for patients with EGFRex20ins+ NSCLC...
Evidence Level:
Sensitive: C3 – Early Trials
Title:

P50.05 - Natural History and Real-World Treatment Outcomes for NSCLC Patients with EGFR Exon 20 Insertion Mutation: An IASLC- ASCO CancerLinQ Study

Published date:
08/18/2021
Excerpt:
Stage 4 patients that received ICI had better survival vs. those who did not (29.1 vs. 14.7 months; p=0.01). Stage 4 patients treated with ICI and chemotherapy had better survival compared to those treated with chemotherapy alone (29.1 vs. 16.5 months, p=0.01)....Stage 4 NSCLC patients with EGFR ex20ins mutation had favorable real-world survival when treated with ICI and targeted therapy.