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Cocktail & Poster Display session

48P - Efficacy analysis and mechanism exploration of furmonertinib for advanced NSCLC with EGFR exon 20 insertion mutation


06 Mar 2023


Cocktail & Poster Display session


Xiao Zhang


Annals of Oncology (2023) 8 (1suppl_2): 100896-100896. 10.1016/esmoop/esmoop100896


X. Zhang1, G. Feng2, H. Han1, B. Dong3, Y. Yang4, H. Zhu1, S. Fan5, H. Tang1

Author affiliations

  • 1 Medical Oncology, The Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, 450008 - Zhengzhou/CN
  • 2 Tianjin Key Laboratory Of Radiation Medicine And Molecular Nuclear Medicine,institute Of Radiation Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, 300192 - Tianjin/CN
  • 3 Medical Oncology, Zhoukou Central Hospital, 466000 - Zhoukou/CN
  • 4 Respiratory And Critical Illness Area, Zhumadian Central Hospital, Zhumadian/CN
  • 5 Radiation Damage Treatment Area, Chinese Academy of Medical Sciences and Peking Union Medical College, 300192 - Tianjin/CN


This content is available to ESMO members and event participants.

Abstract 48P


Here, we analyzed the clinical efficacy of furmonertinib, a novel 3rd generation EGFR TKI, in advanced NSCLC patients (pts) who harboring EGFRex20ins and explored mechanism.


A retrospective single-arm analysis was performed to evaluate the efficacy of 20 NSCLC pts harboring EGFRex20ins receiving furmonertinib treatment from three institutions. Meanwhile, we investigated the clinical efficacy of furmonertinib versus osimertinib as second-line treatment, because pts about furmonertinib as first-line treatment were immature. In addition, the binding activity of different EGFR TKIs to EGFRex20ins were computationally constructed based on the crystal structure of EGFR D770_N771insNPG/V948R (PDB ID: 7LGS) by the Schrödinger software (2021-2 Release, Schrödinger Inc., Portland, Oregon).


Of the 20 pts selected, we found that EGFR S768_D770dup (n=5) variants were more common. Six first-line pts all achieved PR (ORR: 100.0%), five of the eight second-line pts achieved PR (ORR: 62.5%), and three of the six multiple-line pts achieved PR (ORR: 50.0%). We observed 14 pts with PR and six pts with SD as best response to furmonertinib (ORR: 70.0%, DCR: 100%). All pts showed tumor shrinkage in target lesions (median best percent change, -36.43% [-74.78%, -5.56%]). Median PFS was 10.2 (95 % CI, 7.19-13.21) months(mo). Median DOR was 8.5 (95 % CI, 4.97-12.03) mo. Comparative analysis of the efficacy of different groups showed that median PFS was significantly longer in furmonertinib group than in osimertinib (10.2 vs 3.8 mo, p = 0.008). Median OS was numerically longer in furmonertinib group than in osimertinib (18.9 vs 11.7 mo, p = 0.207). No grade 3 or above adverse events were observed. Furthermore, rather than erlotinib (GlideScore: -5.564; MM/GBSA: -52.8044), gefitinib (-7.68; -47.317), and afatinib (-5.075; -44.64), furmonertinib (-11.085; -68.1575) and osimertinib (-10.031; -63.87) revealed favorable binding activity to EGFRex20ins, with furmonertinib being the most significant.


Furmonertinib has positive clinical efficacy to advanced NSCLC pts with EGFRex20ins probably based on its favorable binding activity to EGFRex20ins. Furmonertinib may be the optimal choice for these pts in the future.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

H. Tang.


Natural Science Foundation of Henan Province 212300410400.


All authors have declared no conflicts of interest.

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