EGFR exon 20 insertions (excluding A763_Y764insFQEA) are insensitive to classical EGFR-TK...
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
| ID | BMA-EGFR-EX20INS-NSCLC |
|---|---|
| Type | Actionability |
| Status | reviewed 2026-04-27 | pending_clinical_signoff | actionability review required |
| Diseases | DIS-NSCLC |
| Sources | SRC-CIVIC SRC-ESMO-NSCLC-METASTATIC-2024 SRC-NCCN-NSCLC-2025 |
Actionability Facts
| Biomarker | BIO-EGFR-MUTATION |
|---|---|
| Variant | exon 20 insertion |
| Disease | DIS-NSCLC |
| ESCAT tier | IA |
| Recommended combinations | amivantamab + carboplatin + pemetrexed (PAPILLON 1L), amivantamab monotherapy (2L), platinum-doublet chemotherapy (alternative) |
| Contraindicated monotherapy | osimertinib (poor activity in classical ex20ins), gefitinib / erlotinib / afatinib (resistant), mobocertinib (withdrawn 2023-2024) |
| Evidence summary | 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 Mobocertinib was withdrawn globally 2023-2024 for failed confirmatory trial.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. |
Notes
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.
Used By
No reverse references found in the YAML corpus.