EGFR exon 19 deletion is the most common actionable EGFR-sensitizing mutation in NSCLC ad...

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ID	`RF-NSCLC-EGFR-EX19DEL-ACTIONABLE`
Tipo	Sinal de alerta
Estado	reviewed 2026-04-27 \| pending_clinical_signoff
Doenças	`DIS-NSCLC`
Fontes	`SRC-ESMO-NSCLC-METASTATIC-2024` `SRC-FLAURA-SORIA-2018` `SRC-MARIPOSA2-PASSARO-2024` `SRC-NCCN-NSCLC-2025`

Origem da bandeira vermelha

Definição	EGFR exon 19 deletion is the most common actionable EGFR-sensitizing mutation in NSCLC adenocarcinoma (~45-50% of EGFR-mutant cases). FDA/EMA-approved 1L targeted therapy is osimertinib (FLAURA — mPFS 18.9 vs 10.2 mo, OS 38.6 vs 31.8 mo); MARIPOSA-2 establishes 2L amivantamab + lazertinib + chemo post-osimertinib progression.
Direcção clínica	intensificar
Categoria	high-risk-biology
Algoritmo de deslocamentos	ALGO-NSCLC-METASTATIC-1L, ALGO-NSCLC-METASTATIC-2L

Lógica de Desencadeamento

{
  "any_of": [
    {
      "finding": "egfr_exon19_deletion",
      "value": true
    },
    {
      "finding": "egfr_ex19del",
      "value": "positive"
    },
    {
      "finding": "egfr_mutation",
      "value": "exon19_deletion"
    }
  ],
  "type": "biomarker"
}

Notas

Routes 1L → osimertinib 80 mg PO daily (FLAURA). Acquired-resistance surveillance: ctDNA at progression for T790M (rare on osimertinib), C797S (~20% of post-osimertinib resistance), MET amplification, histologic transformation. 2L: MARIPOSA-2 amivantamab + lazertinib ± chemo. Stage I-IIIA resected — adjuvant osimertinib (ADAURA). Access UA: osimertinib not consistently NSZU-reimbursed; major barrier; consider patient-assistance programs.

Usado por

Algoritmos

ALGO-NSCLC-ADJUVANT - ALGO-NSCLC-ADJUVANTE
ALGO-NSCLC-METASTATIC-1L - ALGO-NSCLC-METASTATIC-1L
ALGO-NSCLC-METASTATIC-2L - ALGO-NSCLC-METASTATIC-2L
ALGO-NSCLC-RESECTABLE-PERIOP - ALGO-NSCLC-RESECTABLE-PERIOP

Capítulos do Manual

HB-NSCLC-METASTATIC-1L - NSCLC metastático: raciocínio do primeiro tratamento com o condutor

Perguntas do Manual

HQ-NSCLC-MET-1L-002 - HQ-NSCLC-MET-1L-002