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Association details:
Evidence:
Evidence Level:
Sensitive: A2 - Guideline
Source:
Published date:
03/16/2022
Excerpt:
The NCCN NSCLC Panel has preference stratified the systemic therapy regimens and decided that afatinib or osimertinib are preferred options for patients with metastatic NSCLC and EGFR L861Q, G719X, and S768I mutations…
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

Phase II study of 5 years of adjuvant osimertinib in completely resected EGFRm NSCLC Estudio de fase II de 5 años del tratamiento adyuvante con osimertinib en el cáncer de pulmón no microcítico con mutación del receptor del factor de crecimiento epidérmico completamente resecado.

Excerpt:
...Staging will be according to the pTNM (pathologic tumour,node, metastasis) staging system for lung cancer 8) Confirmation by the local laboratory that the tumour harbours 1 of the following EGFRmutations:-1 of the 2 common EGFR mutations (Ex19del, L858R), either alone or incombination with other EGFR mutations including de novo T790M and excluding allexon 20 insertions (Common EGFRm Cohort); or - Uncommon EGFR mutations G719X, S768I, and L861Q, either alone, in combination with each other, or in combination with other uncommon EGFR mutations (excluding all exon 20 insertions) (Uncommon EGFRm Cohort).9) Complete surgical resection of the primary NSCLC is mandatory. ...
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

The Efficacy and Safety of Osimertinib with Platinum plus Pemetrexed Chemotherapy, as First-Line Treatment in Recurrent or Locally Advanced or Metastatic Non-Small Cell Lung Cancer (NSCLC) Patients with Uncommon Epidermal Growth Factor Receptor Mutations (EGFRm): A Phase II, Open Label, Single Arm, Multicenter, Exploratory&#32

Excerpt:
...According to the ARMS or Super-ARMS or NGS test results of tumor tissue or plasma from a certified laboratory approved by Chinese regulatory authorities, the tumor carries at least one of the 4 rare EGFR mutations (G719X/L861Q/S768I/T790M) (single mutation or compound mutation), but not other EGFR mutations (including ex19del/L858R). ...
More C2 evidence
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

Study to Assess the Efficacy and Safety of Adjuvant Osimertinib in NSCLC With Uncommon EGFRm

Excerpt:
...At least one documented uncommon EGFR mutation of G719X/L861Q/S768I/de novo T790M without EGFR Ex19del/L858R/exon 20 insertion as detected in tumour tissue, through real-time PCR or NGS analysis from accredited laboratories approved by the Chinese regulatory authority....
Trial ID:
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

Study of Osimertinib in Patients With a Lung Cancer With Brain or Leptomeningeal Metastases With EGFR Mutation

Excerpt:
...L858R, exon 19 deletions, exon 19 insertions, L861Q, G719X....
Trial ID:
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

A Study Osimertinib in Patients With Stage 4 Non-small Cell Lung Cancer With Uncommon EGFR Mutations

Excerpt:
...- EGFR mutations as performed on a CLIA certified laboratory demonstrating EGFR exon 18 G719X, exon 20 S768I, or exon 21 L861Q....
Trial ID:
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

Intrathecal Pemetrexed for Leptomeningeal Metastasis in EGFR-Mutant NSCLC

Excerpt:
...EGFR activating mutations include exon19 deletion, T790M, L858R, G719X, L861Q, or S768I....
Trial ID:
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

Osimertinib Plus Chemotherapy in Uncommon EGFRm NSCLC

Excerpt:
...The tumour harbors at least 1 of the 4 uncommon EGFR mutations (G719X/L861Q/S768I/T790M), either alone or in combination, which...
Trial ID:
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

Dasatinib and Osimertinib (AZD9291) in Advanced Non-Small Cell Lung Cancer With EGFR Mutations

Excerpt:
...- Presence of sensitizing EGFR mutations (deletion in exon 19, L858R in exon 21, G719X, and L861Q)....
Trial ID:
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

Osimertinib (AZD9291) in First-line Locally Advanced or Metastatic NSCLC Patients With EGFR and EGFR T790M

Excerpt:
...- Patients with a EGFR deletion or mutation in exon 19, exon 21 (L858R, L861Q) or exon 18 (G719X) and concomitant T790M mutation before treatment confirmed centrally....
Trial ID:
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

OCEANiC: A Phase II, Open-label, Multi-centre Clinical Trial of Osimertinib With or Without Adjuvant Chemotherapy Guided by Tumour NGS Co-mutation Status and ctDNA Detection in Patients WithnStage IIA-IIIA EGFR-Mutant Non Small Cell Lung Cancer Following Complete Surgical Resection

Excerpt:
...These include exon 19 deletions, L858R (exon 21), G719X (exon 18), L861Q (exon 21), S768I (exon 20) and T790M (exon 20). ...
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

TAGRISSO (Osimertinib) in NSCLC Patients in Whom T790 Mutations Are Detected by Liquid Biopsy

Excerpt:
...Patients with EGFR sensitizing mutation (E19Del, L858R, L861Q, G719X) positive, who had shown clinical benefits (responders (CR or PR) and SD ≥6 months) from EGFR-TKIs and had developed progressive disease following those therapy...
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

Study to Assess the Effect of AZD9291 on the Blood Levels of Rosuvastatin, in Patients With EGFRm+ Non-small Cell Lung Cancer

Excerpt:
...Confirmation that the tumour harbours an EGFR mutation known to be associated with EGFR TKI sensitivity (including G719X, exon 19 deletion, L858R, L861Q)....
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

Phase I, Study in Chinese NSCLC Patients

Excerpt:
...- Documented EGFR mutation (at any time since the initial diagnosis of NSCLC) known to be associated with EGFR TKI sensitivity (including G719X, exon 19 deletion, L858R, L861Q) 6....
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

A Study of Osimertinib with or without Chemotherapy versus Chemotherapy alone as neoadjuvant therapy for Patients with Epidermal Growth Factor Receptor mutation positive resectable Non-Small Cell Lung Cancer

Excerpt:
...For patients aged <20 years and enrolled in Japan, a written informed consent should be obtained from the patient and his or her legally acceptable representative.- Histologically or cytologically documented non-squamous NSCLC with completely resectable (Stage II - IIIB N2) disease (according to Version 8 of the IASLC Cancer Staging Manual [IASLC Staging Manual in Thoracic Oncology 2016]).- Complete surgical resection of the primary NSCLC must be deemed achievable, as assessed by a Mulit-disciplinary Team (MDT) evaluation (which should include a thoracic surgeon, specialised in oncologic procedures).- Eastern Cooperative Oncology Group (ECOG) PS of 0 or 1 at enrolment, with no deterioration over the previous 2 weeks prior to baseline or day of first dosing.- A tumour which harbours one of the 2 common EGFR mutations known to be associated with EGFR-TKI sensitivity (Ex19del, L858R), either alone or in combination with other EGFR mutations (ie, T790M, G719X, Exon20 insertions, S7681 and L861Q).`...
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

Study to Assess the Effect of AZD9291 on the Blood Levels of Simvastatin in Patients With EGFRm+ NSCLC

Excerpt:
...Confirmation that the tumour harbours an EGFR mutation known to be associated with EGFR TKI sensitivity (including G719X, exon 19 deletion, L858R, L861Q)....
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

Study to Assess the Effect of Itraconazole (a CYP3A4 Inhibitor) on the Pharmacokinetics of AZD9291, in Patients With EGFR Positive Non-small Cell Lung Cancer. Patients Will be Chosen From Those Who Have Already Been Prescribed an EGFR TKI Medicine (Such as Iressa or Tarceva)

Excerpt:
...Confirmation that the tumour harbours an EGFR mutation known to be associated with EGFR TKI sensitivity (including G719X, exon 19 deletion, L858R, L861Q)....
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

AZD9291 First Time In Patients Ascending Dose Study

Excerpt:
...- Confirmation that the tumour harbours an EGFR mutation known to be associated with EGFR TKI sensitivity (including G719X, exon 19 deletion, L858R, L861Q) OR...
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

Study to Determine the Effect of Food on the Blood Levels of AZD9291 Following Oral Dosing of a Tablet Formulation in Patients With Non-Small Cell Lung Cancer

Excerpt:
...Confirmation that the tumour harbours an EGFR mutation known to be associated with EGFR TKI sensitivity (including G719X, exon 19 deletion, L858R, L861Q)....
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

Open-label PET Study With [11C]Osimertinib in Patients With EGFRm NSCLC and Brain Metastases

Excerpt:
...Confirmation that the tumour harbours an EGFR mutation known to be associated with EGFR-TKI sensitivity (including G719X, exon 19 deletion, L858R, L861Q) or T790M EGFR resistance mutation as assessed by local laboratory/or central laboratory via tissue/cytology or in plasma....
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

Neoadjuvant Osimertinib + Chemotherapy for EGFR-mutant Stage III NSCLC

Excerpt:
...- A tumour which harbours one of the 2 common EGFR mutations known to be associated with EGFR-TKI sensitivity (Ex19del, L858R), either alone or in combination with other EGFR mutations (ie, T790M, G719X, Exon20 insertions, S7681 and L861Q)....
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

Osimertinib in First and Second Line Treatment of NSCLC Harboring EGFR Mutations From Circulating Tumor DNA

Excerpt:
...Activating EGFR mutation (G719X, exon 19 deletion, L858R, L861Q) detected from circulating tumor DNA either by PANA mutyper® or Cobas® EGFR mutation test....
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

Study to Assess the Effect of Rifampicin on Blood Levels and Safety of AZD9291, in Patients With EGFRm+ NSCLC

Excerpt:
...Confirmation that the tumour harbours an EGFR mutation known to be associated with EGFR TKI sensitivity (including G719X, exon 19 deletion, L858R, L861Q)....
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

this trial is finalized to evaluate the tolerability and the quality of life in patients with Lung cancer who take AZD9291 Questa sperimentazione ¿ finalizzata a valutare la tollerabilit¿ e l'impatto sulla qualit¿ della vita dei pazienti affetti da tumore polmonare che assumono AZD9291

Excerpt:
...Patients must fulfil one of the following:• Confirmation that the tumour harbours an EGFR mutation known to be associated with EGFR TKI sensitivity (including G719X, exon 19 deletion, L858R, L861Q)• OR• Must have experienced clinical benefit from EGFR-TKI, according to the Jackman criteri (Jackman et al 2010) followed by systemic objective progression (RECIST or WHO) while on continuous treatment with EGFR TKI7. ...
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

A Study of Osimertinib With or Without Chemotherapy Versus Chemotherapy Alone as Neoadjuvant Therapy for Patients With EGFRm Positive Resectable Non-Small Cell Lung Cancer

Excerpt:
...- A tumour which harbours one of the 2 common EGFR mutations known to be associated with EGFR-TKI sensitivity (Ex19del, L858R), either alone or in combination with other EGFR mutations (eg., T790M, G719X, Exon20 insertions, S7681 and L861Q)....
Evidence Level:
Sensitive: C2 – Inclusion Criteria
New
Title:

A Study of 5 Years of Adjuvant Osimertinib in Completely Resected Epidermal Growth Factor Receptor Mutation (EGFRm) Non-small Cell Lung Carcinoma (NSCLC)

Excerpt:
...Confirmation by the local laboratory that the tumour harbours one of the two common EGFR mutations (Ex19del, L858R), either alone or in combination with other EGFR mutations including de novo EGFR mutation resulting in substitution of threonine with methionine at amino acid position 790 in exon 20 of EGFR (T790M) or uncommon EGFR mutations G719X, S768I, and L861Q, either alone, in combination with each other, or in combination with other uncommon EGFR mutations (excluding all exon 20 insertions) (Uncommon EGFRm Cohort)....
Trial ID:
Less C2 evidence
Evidence Level:
Sensitive: C3 – Early Trials
Title:

Osimertinib in non-small cell lung cancer with uncommon EGFR-mutations : a post-hoc subgroup analysis with pooled data from two phase II clinical trials

Published date:
06/29/2023
Excerpt:
Of 299 enrolled patients in the two trials, 21 patients with uncommon mutations were identified; 12 patients had a single mutation (G719X or L861Q), one patient had L861Q and an exon 20 insertion, and 8 patients had compound mutations with G719X and either L861Q or S768I....ORR was 47.6% and disease control rate (DCR) 85.7%. The median duration of response (DoR) was 7.9 months. Among 11 patients treated with osimertinib in first line, ORR was 63.6% vs. 30.0% of 10 previously treated patients. The median PFS was 5.5 months in both groups. Patients with G719X-compound mutations had a higher response rate (62.5% vs. 38.5%), a longer median PFS (13.7 vs. 3.5 months) and median OS (29.3 vs. 7.5 months) than patients with other mutations.
DOI:
10.21037/tlcr-21-995
Evidence Level:
Sensitive: C3 – Early Trials
Title:

Osimertinib in NSCLC With Atypical EGFR-Activating Mutations: A Retrospective Multicenter Study

Published date:
01/09/2023
Excerpt:
The most frequent EGFR mutations were L861Q (40%, n = 18), G719X (28%, n = 14), and exon 20 insertion (14%, n = 7). The median TTD of osimertinib was 9.7 months (95% confidence interval [CI]: 6.5-12.9 mo) overall and 10.7 months (95% CI: 3.2-18.1 mo) in the first-line setting (n = 20). The objective response rate was 31.7% (95% CI: 18.1%-48.1%) overall and 41.2% (95% CI: 18.4%-67.1%) in the first-line setting....Osimertinib has activity in patients with NSCLC harboring atypical EGFR mutations.
DOI:
https://doi.org/10.1016/j.jtocrr.2022.100459
Evidence Level:
Sensitive: C3 – Early Trials
Title:

UNcommon EGFR mutations: International Case series on efficacy of osimertinib in Real-life practice in first liNe setting (UNICORN)

Published date:
10/25/2022
Excerpt:
This is a multi-center, retrospective study of ucEGFRmut (exon 20 insertions excluded) metastatic NSCLC osimertinib-treated as first EGFR inhibitor....The largest subgroups were G719X (30%), L861Q (20%) and de novo T790M (15%)….For L861Q ORR was 80%, mPFS 16m and mDOR 16m….Osimertinib demonstrated activity in ucEGFRmut with high rate of disease control systemically and intracranially.
DOI:
10.1016/j.jtho.2022.10.004
Evidence Level:
Sensitive: C3 – Early Trials
Source:
Title:

1206P - UNcommon EGFR mutations: International Case series on efficacy of Osimertinib in Real-life practice in first-liNe setting (UNICORN)

Published date:
09/13/2021
Excerpt:
This is a multi-center, international, academic-initiated retrospective study of mNSCLC with ucEGFRmut treated with osimertinib prior to any other EGFRi….Median DOR was 17.4 months (95% CI 9.1-NA). RR for G719X was 43.8%, 33.3% for T790M, and 71.4% for L861Q....Median PFS was 9.1 months (95% CI 8.1–19.2). Median OS was 18.4 months (95% CI 13.5-NR)....Osimertinib showed activity in ucEGFRmut with 85% disease control rate and encouraging PFS and DOR. This report comprises, to the best of our knowledge, the largest dataset of osimertinib as the first EGFRi for ucEGFRmut.
Evidence Level:
Sensitive: C3 – Early Trials
Source:
Title:

145P-UpSwinG: real-world, non-interventional cohort study on TKI activity in patients (pts) with EGFR mutation-positive (EGFRm+) NSCLC with uncommon mutations

Published date:
03/17/2021
Excerpt:
Uncommon mutation categories were: major uncommon (G719X, L861Q, S768I; 73%); compound (35%); ex20ins (12%); T790M (7%); other (9%). Most pts (n = 226; 92%) were treated in 1st-line with an EGFR TKI; 132 (54%), 70 (28%), 35 (14%) and 7 (3%) received afatinib, gefitinib, erlotinib and osimertinib....Overall median OS was 24.4 mos....ORR was 42% overall (major: 50%; compound: 49%; other: 44%; T790M: 20%; ex20ins: 17%); afatinib: 44% (DoR: 12.0 mos); 1st-gen TKIs: 44% (DoR: 11.0 mos)....Response was highest in pts with major uncommon, and/or compound mutations.
Trial ID:
Evidence Level:
Sensitive: C3 – Early Trials
Source:
Title:

Osimertinib in non-small cell lung cancer (NSCLC) with atypical EGFR activating mutations: A retrospective multicenter study.

Published date:
05/13/2020
Excerpt:
...Fifty-one NSCLC pts with uncommon EGFR mutations...The most frequent mutations were L861Q (35.3%,N=18), G719X (27.5%, N=14), and Exon 20 ins (15.7%, N=8).Osi was used in the 1L setting in 39.2% (N=20).Median time on osi was 7.1 months (mo.) in the overall cohort (95% CI, 5.4 to 8.8 mo.) and 8.9 mo.(95% CI, 7.0 to 10.8 mo.) in pts receiving 1L osi.Patients harboring G719X (N=4) and L861Q (N=10) mutations had a median time on 1L osimertinib of 5.8 mo. and 19.3 mo.,respectively.One patient’s tumor had an EGFR exon 19 ins and was on 1L osi with a partial response for 16.8 months.Two patients with Exon 20 ins were on 1L osi for 9.3 mo. and 8 mo.,respectively....Patients with L861Q and Exon 19 insertion appeared to benefit the most from osi in this time on treatment retrospective analysis.
DOI:
10.1200/JCO.2020.38.15_suppl.9570
Evidence Level:
Sensitive: C3 – Early Trials
New
Title:

Clinicopathologic Characteristics, Treatment Outcomes, and Acquired Resistance Patterns of Atypical EGFR Mutations and HER2 Alterations in Stage IV Non–Small-Cell Lung Cancer

Excerpt:
This difference in PFS was maintained even when we restricted our analysis to patients who first received afatinib or osimertinib (respectively, 7 vs. 15.5 months; P < .002; HR ¼ 0.81;...Median PFS across EGFR subtypes was as follows: exon 19 del (17 months), L858R (18 months), G719X/L861Q (7 months), and exon 20 insertion (5 months). Median OS across EGFR subtypes was as follows: exon 19 del (63 months), L858R (73 months), G719X/L861Q (30 months), and exon 20 insertion (16 months).
DOI:
https://doi.org/10.1016/j.cllc.2019.11.008
Evidence Level:
Sensitive: C3 – Early Trials
New
Title:

An open-label, multicenter, phase II single arm trial of osimertinib in non-small cell lung cancer patients with uncommon EGFR mutation (KCSG-LU15-09).

Excerpt:
The most common mutations are G719A/C/D/S/X (19, 52.8%) followed by L861Q (9, 25%), S7681 (8, 22%), and others (4, 11%). The overall response rate was 50.0% (95% CI 32.8-67.2) and DCR was 88.9% (95% CI 78.1-99.7). Seven patients (77.8%) with L861Q mutation achieved partial response; 10 (52.6%) with G719A/C/D/S/X mutation; three (37.5%) with S768I mutation....Osimertinib showed highly active and durable in NSCLC patients harboring uncommon EGFR mutation with manageable safety profile, consistent with previous reports.
Trial ID: