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EGFR T790M is the dominant acquired-resistance mechanism after 1st/2nd-gen EGFR-TKI (gefi...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

IDBMA-EGFR-T790M-NSCLC
TypeActionability
Statusreviewed 2026-04-27 | pending_clinical_signoff | actionability review required
DiseasesDIS-NSCLC
SourcesSRC-CIVIC SRC-ESMO-NSCLC-METASTATIC-2024 SRC-NCCN-NSCLC-2025

Actionability Facts

BiomarkerBIO-EGFR-MUTATION
VariantT790M
DiseaseDIS-NSCLC
ESCAT tierIA
Recommended combinationsosimertinib monotherapy
Contraindicated monotherapygefitinib (T790M-resistant), erlotinib (T790M-resistant), afatinib (T790M-resistant)
Evidence summaryEGFR T790M is the dominant acquired-resistance mechanism after 1st/2nd-gen EGFR-TKI (gefitinib/erlotinib/afatinib). Osimertinib (3rd-gen) is active against T790M and is standard 2L (AURA3, Mok et al. 2017). In the modern era T790M is rarely encountered de novo since osimertinib has moved to 1L; remains relevant after legacy 1L-TKI use.

Notes

ESCAT IA. OncoKB Level 1. ctDNA testing at progression on 1st/2nd-gen TKI is standard; tissue rebiopsy if plasma negative. Companion diagnostic: cobas EGFR Mutation Test v2.

Used By

No reverse references found in the YAML corpus.