EGFR exon 20 insertions (excluding A763_Y764insFQEA) are insensitive to classical EGFR-TK...
Vista determinista de la entidad fuente YAML. La autoridad clínica sigue con los ID de fuente citados y estado de firma del revisor.
| ID | BMA-EGFR-EX20INS-NSCLC |
|---|---|
| Tipo | Relevancia terapéutica |
| Situación | reviewed 2026-04-27 | pending_clinical_signoff | actionability review required |
| Enfermedades | DIS-NSCLC |
| Fuentes | SRC-CIVIC SRC-ESMO-NSCLC-METASTATIC-2024 SRC-NCCN-NSCLC-2025 |
Hechos relativos a la posibilidad de adoptar medidas
| Biomarcador | BIO-EGFR-MUTATION |
|---|---|
| Variante | inserción del exón 20 |
| Enfermedad | DIS-NSCLC |
| El nivel de ESCAT | IA |
| Combinaciones recomendadas | amivantamab + carboplatin + pemetrexed (PAPILLON 1L), amivantamab monotherapy (2L), platinum-doublet chemotherapy (alternative) |
| Monoterapia contraindicada | osimertinib (poor activity in classical ex20ins), gefitinib / erlotinib / afatinib (resistant), mobocertinib (withdrawn 2023-2024) |
| Resumen de las pruebas | EGFR exon 20 insertions (excluding A763_Y764insFQEA) are insensitive to classical EGFR-TKIs. Amivantamab (EGFR-MET bispecific) + chemo is 1L standard (PAPILLON, Zhou et al. 2023). Mobocertinib was withdrawn globally 2023-2024 for failed confirmatory trial. Sunvozertinib (China-approved) is an emerging option in 2L. |
Notas
ESCAT IA per PAPILLON. OncoKB Level 1. NGS preferred over PCR for detection — many ex20ins variants missed by hotspot PCR panels. A763_Y764insFQEA is the rare classical-TKI-sensitive exception.
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