Find a Doctor Find a Doctor
Time to see a specialist?
Time to see a specialist?
We found [COUNT] Specialists
who treat [INTEREST]
near [LOCATION]
We found [COUNT] Specialists
who treat [INTEREST]
near [LOCATION]
[TELEHEALTH] offer Telehealth options.
More
Treating Non-Small Cell Lung Cancer

This content is created by Healthgrades and brought to you by an advertising sponsor. More

This content is created or selected by the Healthgrades editorial team and is funded by an advertising sponsor. The content is subject to the Healthgrades medical review process for accuracy, balance and objectivity. The content is not edited or otherwise influenced by the advertisers appearing on this page except with the possible suggestion of the broad topic area. For more information, read the Healthgrades advertising policy.

Targeting the EGFR Exon 20 Insertion Mutations When Treating Non-Small Cell Lung Cancer

Was this helpful?
8
team of doctors and nurses in circle reviewing medical chart
Getty

Many people with lung cancer, particularly a type of non-small cell lung cancer called adenocarcinoma, have a mutation (or change) in their EGFR gene. EGFR, short for epidermal growth factor receptor, is a protein that normally helps your cells grow. When the EGFR gene is mutated in your lung cells, it can cause them to grow out of control and become cancerous.

Researchers have discovered that there are different kinds of EGFR mutations. One relatively uncommon mutation, called the EGFR exon 20 insertion mutation, has been challenging to treat because it hasn’t responded as well to existing lung cancer treatments. But recently, new drugs have been approved for this particular mutation, providing more options than previously available.

How do I know if I have the EGFR exon 20 insertion mutation?

After you’ve been diagnosed with non-small cell lung cancer, further testing may be performed to check for the presence of the EGFR mutation. Tissue from your tumor or a sample of your blood can be examined to identify mutations in your cancer cells. Some tests can specifically identify what kind of EGFR mutation, if any, is present, including the EGFR exon 20 insertion mutation.

In general, the EGFR exon 20 insertion mutation is more prevalent in:

  • People diagnosed with adenocarcinoma
  • Women
  • Non-smokers
  • Younger individuals

In addition to EGFR, there are several other known mutations associated with lung cancer. You will likely be screened for other mutations at the same time to help your doctor select the best treatment for you.

How is lung cancer with the EGFR exon 20 insertion mutation treated?

People with the most common types of EGFR mutations tend to do well with a class of drugs known as tyrosine kinase inhibitors, but this is not the case for individuals who have the EGFR exon 20 insertion mutation. Instead, this group is often treated with platinum-based chemotherapy, such as cisplatin and carboplatin. Immune checkpoint inhibitors, a form of immunotherapy, may also be used. These drugs help the immune system recognize and attack cancer cells.

Two new treatments were recently approved specifically for lung cancer with the EGFR exon 20 insertion mutation. They are targeted therapies, meaning they “target” and block specific changes in cancer cells that help them grow and spread. If you have stage 3 or 4 non-small cell lung cancer that has progressed during or after chemotherapy, you may be a candidate for one of the following:

  • Amivantamab-vmjw (Rybrevent): This is a man-made version of an antibody produced by your immune system. It targets both EGFR and MET (another protein involved in cell growth). It’s given as an IV infusion once a week or every two weeks.
  • Mobocertinib (Exkivity): This is taken as a pill once a day. By blocking EGFR, it slows the growth of lung cancer.

Though major advancements have been made, researchers continue to study new potential targeted therapies for treating all types and stages of lung cancer. Different combinations of existing drugs are also being trialed to look for better and longer responses to treatment. If you have questions about your type of lung cancer and which treatments are recommended for you, reach out to your doctor for guidance.

Was this helpful?
8
Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Oct 12
View All Treating Non-Small Cell Lung Cancer Articles
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Incorporating Immune Checkpoint Inhibitors Into the Treatment of EGFR ex20ins NSCLC Tumors. American Society of Clinical Oncology. https://dailynews.ascopubs.org/do/10.1200/ADN.21.200468/full/
  2. EGFR and Lung Cancer. American Lung Association. https://www.lung.org/lung-health-diseases/lung-disease-lookup/lung-cancer/symptoms-diagnosis/biomarker-testing/egfr
  3. FDA Approves First Targeted Therapy for Subset of Non-Small Cell Lung Cancer. U.S. Food and Drug Administration. https://www.fda.gov/news-events/press-announcements/fda-approves-first-targeted-therapy-subset-non-small-cell-lung-cancer
  4. FDA grants accelerated approval to mobocertinib for metastatic non-small cell lung cancer with EGFR exon 20 insertion mutations. U.S Food and Drug Administration. https://www.fda.gov/drugs/resources-information-approved-drugs/fda-grants-accelerated-approval-mobocertinib-metastatic-non-small-cell-lung-cancer-egfr-exon-20
  5. Targeted Drug Therapy for Non-Small Cell Lung Cancer. American Cancer Society. https://www.cancer.org/cancer/lung-cancer/treating-non-small-cell/targeted-therapies.html
  6. EGFR Exon Insertion Mutations in Non-Small Cell Lung Cancer. Translational Cancer Research. https://tcr.amegroups.com/article/view/37726/html