Sutetinib for Patients with Non-Small Cell Lung Cancer Harboring Uncommon EGFR Mutations: A Multicenter, Open-Label, Phase IIb Trial
Published report from the trial registered as NCT05168566, in Journal of Thoracic Oncology (2026), chosen as the most cited paper whose own text cites the registry id.
Overview
Purpose: Uncommon epidermal growth factor receptor (EGFR) mutations account for ∼10% of EGFR-altered non-small cell lung cancer (NSCLC) and show heterogeneous sensitivity to EGFR-tyrosine kinase inhibitors (TKIs), with limited prospective evidence to inform first-line therapy. Sutetinib is an irreversible EGFR-TKI. We assessed the safety and antitumor efficacy of sutetinib in patients with locally advanced or metastatic NSCLC with uncommon EGFR mutations.
Methods: In this multicenter, open-label, single-arm phase IIb trial, adults with locally advanced or metastatic NSCLC harboring EGFR G719X, S768I, L861Q, or predefined compound mutations and no prior EGFR-TKI therapy were enrolled. Patients received sutetinib 80 mg orally once daily in 28-day cycles until radiographic progression or unacceptable toxicity. Patients who received at least one dose of treatment and evaluable for efficacy analysis were included in the primary analysis, and all patients who received at least one dose of treatment were included in the safety analysis. The primary endpoint was objective response rate (ORR), as assessed by the independent review committee (IRC). Secondary endpoints included duration of response (DoR), disease control rate (DCR), time to response (TTR), progression-free survival (PFS), overall survival (OS), and safety.
Results: From December 9, 2021, to May 5, 2024, 99 patients were enrolled (efficacy-evaluable, n=96; safety, n=99). at data cut-off in October, 2024, the median follow-up was 16.6 months. The IRC-confirmed ORR was 70.8% (95% confidence interval [CI], 60.7-79.7) and the DCR was 90.6% (95% CI, 82.9-95.6). Median DoR was 12.0 months (95% CI, 9.3-15.7) and median PFS was 13.7 months (95% CI, 10.9-16.4). Median OS was not reached (95% CI, 22.2-not reached). ORR was numerically higher in patients with compound versus solitary uncommon EGFR mutations (84.4% vs 64.1%), with median PFS of 13.8 versus 11.0 months, respectively. Treatment-related adverse events (TRAEs) of any grade occurred in 97.0% (96/99) of patients, and grade ≥3 TRAEs occurred in 42.4% (42/99). The most common grade ≥3 TRAEs were diarrhea (28.3% [28/99]), hypokalemia (8.1% [8/99]), and increased gamma-glutamyl transferase (5.1% [5/99]). TRAEs led to dose reduction in 34.3% (34/99) and treatment discontinuation in 4.0% (4/99). No treatment-related deaths occurred.
Conclusions: Sutetinib met the prespecified primary endpoint and demonstrated clinically meaningful antitumor activity with a manageable safety profile in advanced NSCLC harboring uncommon EGFR mutations (G719X, S768I, and L861Q). These findings support sutetinib as a potential treatment option for this molecularly heterogeneous population.
Trial registration: NCT05168566.
Indexed on Europe PMC as PubMed record 42637134 (DOI 10.1016/j.jtho.2026.104165). Its abstract cites the registry id NCT05168566, which is how it was matched to this trial; no figure has been checked by an editor.
This is the paper Europe PMC returns for registry id NCT05168566 with the most citations, so it is the natural first reading for anyone following the trial. Read the abstract above alongside the trial page and the registry entry; the record was linked automatically and its figures have not been checked by hand.
- Matched to the trial by the registry id cited in the Europe PMC record; the summary reproduces the record's abstract and no figure has been verified against the full paper.