Observational studyAnnals of oncology : official journal of the European Society for Medical Oncology2014
Rare EGFR exon 18 and exon 20 mutations in non-small-cell lung cancer on 10 117 patients: a multicentre observational study by the French ERMETIC-IFCT network.
Observational study in Annals of oncology : official journal of the European Society for Medical Oncology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 178 papers, 3 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
178 citing papers in PubMed, 3 syntheses or guidelines pooled it, 315 citations in OpenAlex.
- Prevalence of Epidermal Growth Factor Receptor Exon 20 Insertion Mutations in Non-small-Cell Lung Cancer in Europe: A Pragmatic Literature Review and Meta-analysis.Targeted oncology · 2022Pooled it
- Therapeutic exploration of uncommon EGFR exon 20 insertion mutations in advanced non-small cell lung cancer: breaking through brambles and thorns.Journal of cancer research and clinical oncology · 2022Pooled it
- The Japanese Lung Cancer Society Guideline for non-small cell lung cancer, stage IV.International journal of clinical oncology · 2019Guideline
- Phase II study of afatinib for advanced non-small cell lung cancer with uncommon epidermal growth factor receptor mutations, including compound mutations detected by next-generation sequencing.International journal of clinical oncology · 2025Trial
- Poziotinib for EGFR exon 20-mutant NSCLC: Clinical efficacy, resistance mechanisms, and impact of insertion location on drug sensitivity.Cancer cell · 2022Trial
- Activity and Safety of Mobocertinib (TAK-788) in Previously Treated Non-Small Cell Lung Cancer withCancer discovery · 2021Trial
- Osimertinib for Patients With Non-Small-Cell Lung Cancer Harboring Uncommon EGFR Mutations: A Multicenter, Open-Label, Phase II Trial (KCSG-LU15-09).Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2020Trial
- EGFR exon 20-altered NSCLC in China: molecular heterogeneity and real-world outcomes with sunvozertinib.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Article
- Afatinib Versus Osimertinib for Non-Small Cell Lung Cancer With Uncommon EGFR Mutations: Real-World Outcomes.Cancer science · 2026Observational
- Patterns of central nervous system disease and molecular landscape in epidermal growth factor receptor exon 20 insertion mutated non-small cell carcinoma.Translational lung cancer research · 2026Article
- Article
- First Line and Treatment Sequencing in EGFR-Mutated Metastatic NSCLC: What is Right for Which Patient?Drugs · 2026Review
- Molecular epidemiology and outcomes ofTranslational lung cancer research · 2026Article
- Updated incidence of EGFR mutation in Middle Eastern patients with non-small cell lung cancer: a 7-year study in a Lebanese institution.BMC cancer · 2026Article
- Clinical outcomes and survival in patients with NSCLC and EGFR exon 20 mutations: evidence from real-world clinical practice in a retrospective study in Galicia.Frontiers in oncology · 2026Article
- Distinct survival, optimal combination strategy of immunotherapy, and immunophenotype in uncommon and 20ins EGFR-mut lung adenocarcinoma: a multi-center study.Molecular biomedicine · 2025Article
- Review
- Current paradigm of EGFRMed (New York, N.Y.) · 2025Review
- Landscape and clinical implications of EGFR exon 20 insertions in non-small cell lung cancer patients.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2025Review
- Comorbidity of hypertension and lung cancer: interplay of genetics and environment.Discover oncology · 2025Review
118 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
27 authors at 14 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere is scarce data available about epidermal growth factor receptor (EGFR) mutations other than common exon 19 deletions and exon 21 (L858R) mutations. PATIENTS AND
methodsEGFR exon 18 and/or exon 20 mutations were collected from 10 117 non-small-cell lung cancer (NSCLC) samples analysed at 15 French National Cancer Institute (INCa)-platforms of the ERMETIC-IFCT network.
resultsBetween 2008 and 2011, 1047 (10%) samples were EGFR-mutated, 102 (10%) with rare mutations: 41 (4%) in exon 18, 49 (5%) in exon 20, and 12 (1%) with other EGFR mutations. Exon 20 mutations were related to never-smoker status, when compared with exon 18 mutations (P < 0.001). Median overall survival (OS) of metastatic disease was 21 months [95% confidence interval (CI) 12-24], worse in smokers than in non-smoker patients with exon 20 mutations (12 versus 21 months; hazard ratio [HR] for death 0.27, 95% CI 0.08-0.87, P = 0.03). Under EGFR-tyrosine kinase inhibitors (TKIs), median OS was 14 months (95% CI 6-21); disease control rate was better for complex mutations (6 of 7, 86%) than for single mutations (16 of 40, 40%) (P = 0.03).
conclusionsRare EGFR-mutated NSCLCs are heterogeneous, with resistance of distal exon 20 insertions and better sensitivity of exon 18 or complex mutations to EGFR-TKIs, probably requiring individual assessment.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.