This protocol addresses patients with advanced or metastatic non-small cell lung cancer (NSCLC) whose tumours carry one or more of the uncommon EGFR point mutations: S768I, L861Q, and/or G719X. These variants represent approximately 10% of EGFR mutations observed in NSCLC, forming a molecularly distinct subgroup with specific first-line treatment guidance.
For patients in this molecular subgroup, first-line EGFR-directed targeted therapy is the recommended approach. Guideline panels have designated both preferred and other recommended agents — the full selection criteria, agent ranking, and treatment algorithm are available in the structured protocol.
Other less common EGFR mutations (approximately 10% of EGFR mutations observed in patients with NSCLC) include S768I, L861Q, and/or G719X.
The Panel recommends afatinib or osimertinib as preferred first-line therapy options for patients with advanced or metastatic NSCLC with EGFR S768I, L861Q, and/or G719X mutations.
Dacomitinib, erlotinib, and gefitinib are other recommended first-line treatment options.
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