Cancer Center, The First Hospital of Jilin University, Changchun, 130021, China.
J Cancer Res Clin Oncol. 2022 Jan;148(1):163-176. doi: 10.1007/s00432-021-03840-y. Epub 2021 Oct 26.
EGFR exon 20 insertion (EGFR ex20ins) mutations account for about 10-12% of all EGFR-mutated tumors, which are usually associated with primary drug resistance to conventional EGFR-TKI therapy and worse survival outcomes, and are currently a major problem for clinicians in clinical management. In recent years, with the rapid improvement of sequencing technology and careful review of clinical data, investigators have gained a deeper understanding and clearer cognition of the clinicopathological features and molecular mechanisms of these EGFR ex20ins mutations.
The aim of this study was to systemically review the molecular structure and clinical characteristics of EGFR ex20ins mutations, and focus on summarizing the latest data of emerging therapies (including novel small-molecule EGFR-TKI drugs, specific monoclonal antibodies, novel drugs targeting other mechanisms, and immunotherapy) for those patients.
Advances in overcoming these systemic challenges have greatly accelerated the development of new drugs targeting EGFR ex20ins, and are committed to designing more rational combination therapies to overcome or delay the emergence of drug resistance, ultimately improve the prognosis of such uncommon mutant populations.
EGFR 外显子 20 插入（EGFR ex20ins）突变约占所有 EGFR 突变肿瘤的 10-12%，通常与传统 EGFR-TKI 治疗的原发性耐药和更差的生存结局相关，目前是临床管理中临床医生面临的主要问题。近年来，随着测序技术的快速发展和对临床数据的仔细审查，研究人员对这些 EGFR ex20ins 突变的临床病理特征和分子机制有了更深入的了解和更清晰的认识。
本研究旨在系统回顾 EGFR ex20ins 突变的分子结构和临床特征，并重点总结新兴疗法（包括新型小分子 EGFR-TKI 药物、特异性单克隆抗体、针对其他机制的新型药物和免疫疗法）治疗此类患者的最新数据。
克服这些系统性挑战的进展极大地加速了针对 EGFR ex20ins 的新药研发，并致力于设计更合理的联合治疗方案，以克服或延迟耐药的出现，最终改善此类罕见突变人群的预后。
