A lung adenocarcinoma with rare epidermal growth factor receptor exon 20 V774M mutation was sensitive to osimertinib: A case report and molecular structural analysis.

Epidermal growth factor receptor (EGFR) mutations are the most common driver mutations in non-small cell lung cancer (NSCLC). EGFR tyrosine kinase inhibitors (EGFR-TKIs) have remarkably improved the prognosis of patients with classical activating mutations (EGFR exon 19 deletion and L858R mutations), but the efficacy of EGFR-TKIs in rare EGFR mutations remains heterogeneous and controversial [ [1] Passaro A. Mok T. Peters S. Popat S. Ahn M.J. de Marinis F. Recent Advances on the Role of EGFR Tyrosine Kinase Inhibitors in the Management of NSCLC With Uncommon, Non Exon 20 Insertions EGFR Mutations. J. Thorac. Oncol. 2021; 16: 764-773 Abstract Full Text Full Text PDF PubMed Scopus (86) Google Scholar ]. Herein, we describe a NSCLC patient with a rare EGFR V774M mutation was sensitive to osimertinib. We also predict the protein structure of EGFR V774M mutation and evaluate the binding ability of different EGFR-TKIs to V774M conformation via in silico analysis.