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EGFR exon 20 — insertions hétérogènes dans le cadre qui bloquent stériquement 1st/2nd/...

Vue déterministe de l'entité source de la LJAM. L'autorité clinique demeure avec les ID de la source cités et l'état d'approbation de l ́examinateur.

IDRF-NSCLC-EGFR-EX20INS-ACTIONABLE
TypeSignal d’alerte
Étatreviewed 2026-04-27 | pending_clinical_signoff
MaladiesDIS-NSCLC
SourcesSRC-CHRYSALIS-PARK-2021 SRC-ESMO-NSCLC-METASTATIC-2024 SRC-NCCN-NSCLC-2025

Origine du drapeau rouge

DéfinitionEGFR exon 20 insertion — heterogeneous in-frame insertions that sterically block 1st/2nd/3rd-gen EGFR-TKI binding. Targeted by amivantamab (EGFR-MET bispecific; CHRYSALIS / PAPILLON) and mobocertinib (where available). PAPILLON established 1L amivantamab + carboplatin/pemetrexed; CHRYSALIS supports 2L+ amivantamab monotherapy.
Direction cliniqueintensifier
Catégoriehigh-risk-biology
Algorithme de décalageALGO-NSCLC-METASTATIC-1L, ALGO-NSCLC-METASTATIC-2L

Logique de déclenchement

{
  "any_of": [
    {
      "finding": "egfr_exon20_insertion",
      "value": true
    },
    {
      "finding": "egfr_ex20ins",
      "value": "positive"
    },
    {
      "finding": "egfr_mutation",
      "value": "exon20_insertion"
    }
  ],
  "type": "biomarker"
}

Notes

~5-10% of EGFR-mutant NSCLC. NGS strongly preferred over PCR for detection (PCR misses non-canonical insertions). Standard EGFR-TKI (osimertinib, erlotinib) inactive — do not treat as classic EGFR mutation. Amivantamab IV q-weekly induction → q-2-weekly maintenance (rapid infusion-reaction premedication required). Mobocertinib voluntarily withdrawn in some markets due to OS data.

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Algorithmes