{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T00:37:53Z","timestamp":1792715873585,"version":"4.5.0"},"reference-count":44,"publisher":"Elsevier BV","issue":"10","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","esmoopen.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["ESMO Open"],"published-print":{"date-parts":[[2026,10]]},"DOI":"10.1016\/j.esmoop.2026.108369","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T19:17:39Z","timestamp":1788895059000},"page":"108369","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Osimertinib in advanced non-small cell lung cancer (NSCLC) harboring different EGFR uncommon variants: real-world data from the Italian biomarker ATLAS database"],"prefix":"10.1016","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-3659-4800","authenticated-orcid":false,"given":"G.","family":"Farinea","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8718-6773","authenticated-orcid":false,"given":"A.","family":"Mogavero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Vitale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Roca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Scotti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Delmonte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Veccia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9210-5149","authenticated-orcid":false,"given":"M.L.","family":"Reale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Bironzo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3690-8582","authenticated-orcid":false,"given":"C.","family":"Genova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4878-5906","authenticated-orcid":false,"given":"D.","family":"Galetta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Bulotta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Grossi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7611-7369","authenticated-orcid":false,"given":"D.","family":"Cortinovis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Novello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2333-704X","authenticated-orcid":false,"given":"E.","family":"Bria","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Passiglia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"3","key":"10.1016\/j.esmoop.2026.108369_bib1","first-page":"229","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J Clin"},{"issue":"9","key":"10.1016\/j.esmoop.2026.108369_bib2","doi-asserted-by":"crossref","first-page":"1515","DOI":"10.3390\/cancers17091515","article-title":"Non-small cell lung cancer with epidermal growth factor receptor (EGFR) common mutations: new strategies","volume":"17","author":"Stanzione","year":"2025","journal-title":"Cancers"},{"issue":"2","key":"10.1016\/j.esmoop.2026.108369_bib3","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1038\/s41571-024-00971-2","article-title":"The changing treatment landscape of EGFR-mutant non-small-cell lung cancer","volume":"22","author":"Zhou","year":"2025","journal-title":"Nat Rev Clin Oncol"},{"key":"10.1016\/j.esmoop.2026.108369_bib4","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.lungcan.2017.11.005","article-title":"A comprehensive review of uncommon EGFR mutations in patients with non-small cell lung cancer","volume":"114","author":"Tu","year":"2017","journal-title":"Lung Cancer"},{"key":"10.1016\/j.esmoop.2026.108369_bib5","doi-asserted-by":"crossref","DOI":"10.1016\/j.currproblcancer.2024.101064","article-title":"Current management of uncommon EGFR mutations in non-small cell lung cancer","volume":"49","author":"Trinh","year":"2024","journal-title":"Curr Probl Cancer"},{"issue":"7","key":"10.1016\/j.esmoop.2026.108369_bib6","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1016\/j.jtho.2024.03.016","article-title":"Unveiling the landscape of uncommon EGFR mutations in NSCLC: a systematic review","volume":"19","author":"Borgeaud","year":"2024","journal-title":"J Thorac Oncol"},{"issue":"7878","key":"10.1016\/j.esmoop.2026.108369_bib7","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1038\/s41586-021-03898-1","article-title":"Structure-based classification predicts drug response in EGFR-mutant NSCLC","volume":"597","author":"Robichaux","year":"2021","journal-title":"Nature"},{"key":"10.1016\/j.esmoop.2026.108369_bib8","article-title":"Compound EGFR mutations are predominantly PACC (P-loop and alpha-C helix compressing) mutations with increased responsiveness to second- vs third-generation tyrosine kinase inhibitors","author":"Liu","year":"2026","journal-title":"J Thorac Oncol"},{"issue":"9","key":"10.1016\/j.esmoop.2026.108369_bib9","doi-asserted-by":"crossref","first-page":"1146","DOI":"10.1016\/j.jtho.2023.05.028","article-title":"The role of germline mutations in thoracic malignancies: between myth and reality","volume":"18","author":"Farinea","year":"2023","journal-title":"J Thorac Oncol"},{"issue":"1","key":"10.1016\/j.esmoop.2026.108369_bib10","doi-asserted-by":"crossref","first-page":"6791","DOI":"10.1038\/s41467-022-34398-z","article-title":"Biochemical and structural basis for differential inhibitor sensitivity of EGFR with distinct exon 19 mutations","volume":"13","author":"van Alderwerelt van Rosenburgh","year":"2022","journal-title":"Nat Commun"},{"issue":"30","key":"10.1016\/j.esmoop.2026.108369_bib11","doi-asserted-by":"crossref","DOI":"10.1073\/pnas.2206588119","article-title":"Allele-specific activation, enzyme kinetics, and inhibitor sensitivities of EGFR exon 19 deletion mutations in lung cancer","volume":"119","author":"Brown","year":"2022","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"6","key":"10.1016\/j.esmoop.2026.108369_bib12","article-title":"First-line osimertinib for lung cancer with uncommon EGFR exon 19 mutations and EGFR compound mutations","volume":"5","author":"Cheunkarndee","year":"2024","journal-title":"JTO Clin Res Rep"},{"issue":"4","key":"10.1016\/j.esmoop.2026.108369_bib13","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1016\/j.jtho.2024.12.012","article-title":"Decoding the clinical and molecular signatures of EGFR common, compound, and uncommon mutations in NSCLC: a brief report","volume":"20","author":"Tavernari","year":"2025","journal-title":"J Thorac Oncol"},{"key":"10.1016\/j.esmoop.2026.108369_bib14","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/j.ejca.2020.10.005","article-title":"Clinical impact of uncommon epidermal growth factor receptor exon 19 insertion-deletion variants on epidermal growth factor receptor-tyrosine kinase inhibitor efficacy in non-small-cell lung cancer","volume":"141","author":"Peng","year":"2020","journal-title":"Eur J Cancer"},{"issue":"7","key":"10.1016\/j.esmoop.2026.108369_bib15","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1016\/S1470-2045(15)00026-1","article-title":"Clinical activity of afatinib in patients with advanced non-small-cell lung cancer harbouring uncommon EGFR mutations: a combined post hoc analysis of LUX-Lung 2, LUX-Lung 3, and LUX-Lung 6","volume":"16","author":"Yang","year":"2015","journal-title":"Lancet Oncol"},{"issue":"18","key":"10.1016\/j.esmoop.2026.108369_bib16","doi-asserted-by":"crossref","first-page":"2049","DOI":"10.1200\/JCO-24-02007","article-title":"Pragmatic randomized study of afatinib versus chemotherapy for patients with non-small cell lung cancer with uncommon epidermal growth factor receptor mutations: ACHILLES\/TORG1834","volume":"43","author":"Miura","year":"2025","journal-title":"J Clin Oncol"},{"issue":"1","key":"10.1016\/j.esmoop.2026.108369_bib17","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1056\/NEJMoa1913662","article-title":"Overall survival with osimertinib in untreated, EGFR-mutated advanced NSCLC","volume":"382","author":"Ramalingam","year":"2020","journal-title":"N Engl J Med"},{"issue":"6","key":"10.1016\/j.esmoop.2026.108369_bib18","doi-asserted-by":"crossref","DOI":"10.1016\/j.esmoop.2024.103592","article-title":"Activity of osimertinib in non-small cell lung Cancer with UNcommon epidermal growth factor receptor mutations: retrospective observational multicenter study (ARTICUNO)","volume":"9","author":"Pizzutilo","year":"2024","journal-title":"ESMO Open"},{"issue":"2","key":"10.1016\/j.esmoop.2026.108369_bib19","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.jtho.2022.10.004","article-title":"Uncommon EGFR mutations: international case series on efficacy of osimertinib in real-life practice in first-line setting (UNICORN)","volume":"18","author":"Bar","year":"2023","journal-title":"J Thorac Oncol"},{"issue":"1","key":"10.1016\/j.esmoop.2026.108369_bib20","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1001\/jamaoncol.2023.5013","article-title":"First-line osimertinib for previously untreated patients with NSCLC and uncommon EGFR mutations: the UNICORN phase 2 nonrandomized clinical trial","volume":"10","author":"Okuma","year":"2024","journal-title":"JAMA Oncol"},{"issue":"9","key":"10.1016\/j.esmoop.2026.108369_bib21","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1016\/j.jtho.2025.05.006","article-title":"Lazertinib for patients with NSCLC harboring uncommon EGFR mutations: a phase II multicenter trial","volume":"20","author":"Park","year":"2025","journal-title":"J Thorac Oncol"},{"key":"10.1016\/j.esmoop.2026.108369_bib22","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1200\/JCO-24-02835","article-title":"Amivantamab plus lazertinib in atypical EGFR-mutated advanced non-small cell lung cancer: results from CHRYSALIS-2","volume":"44","author":"Tomasini","year":"2026","journal-title":"J Clin Oncol"},{"issue":"2","key":"10.1016\/j.esmoop.2026.108369_bib23","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/j.ejca.2008.10.026","article-title":"New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1)","volume":"45","author":"Eisenhauer","year":"2009","journal-title":"Eur J Cancer"},{"issue":"1","key":"10.1016\/j.esmoop.2026.108369_bib24","doi-asserted-by":"crossref","first-page":"CNS28","DOI":"10.2217\/cns-2018-0007","article-title":"Use of the Response Assessment in Neuro-Oncology (RANO) criteria in clinical trials and clinical practice","volume":"8","author":"Chukwueke","year":"2019","journal-title":"CNS Oncol"},{"key":"10.1016\/j.esmoop.2026.108369_bib25","article-title":"Safety and efficacy of osimertinib in patients with non-small-cell lung cancer and uncommon tumoral epidermal growth factor receptor mutations: a systematic review and single-arm meta-analysis","volume":"8","author":"Priantti","year":"2024","journal-title":"JCO Precis Oncol"},{"key":"10.1016\/j.esmoop.2026.108369_bib26","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1038\/s41571-025-01085-z","article-title":"Navigating the landscape of EGFR TKI resistance in EGFR-mutant NSCLC\u2014mechanisms and evolving treatment approaches","volume":"23","author":"Zhao","year":"2026","journal-title":"Nat Rev Clin Oncol"},{"issue":"8043","key":"10.1016\/j.esmoop.2026.108369_bib27","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1038\/s41586-024-08167-5","article-title":"Automated real-world data integration improves cancer outcome prediction","volume":"636","author":"Jee","year":"2024","journal-title":"Nature"},{"issue":"2","key":"10.1016\/j.esmoop.2026.108369_bib28","article-title":"The potential of lazertinib and amivantamab combination therapy as a treatment strategy for uncommon EGFR-mutated NSCLC","volume":"6","author":"Oh","year":"2025","journal-title":"Cell Rep Med"},{"issue":"11","key":"10.1016\/j.esmoop.2026.108369_bib29","doi-asserted-by":"crossref","first-page":"1332","DOI":"10.1016\/j.annonc.2021.07.016","article-title":"EANO-ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up of patients with brain metastasis from solid tumours","volume":"32","author":"Le Rhun","year":"2021","journal-title":"Ann Oncol"},{"key":"10.1016\/j.esmoop.2026.108369_bib30","doi-asserted-by":"crossref","DOI":"10.1016\/j.critrevonc.2024.104540","article-title":"Role of osimertinib plus brain radiotherapy versus osimertinib single therapy in EGFR-mutated non-small-cell lung cancer with brain metastases: a meta-analysis and systematic review","volume":"205","author":"Nepote","year":"2025","journal-title":"Crit Rev Oncol Hematol"},{"key":"10.1016\/j.esmoop.2026.108369_bib31","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.lungcan.2022.01.014","article-title":"Impact of EGFR exon 19 deletion subtypes on clinical outcomes in EGFR-TKI-treated advanced non-small-cell lung cancer","volume":"166","author":"Huang","year":"2022","journal-title":"Lung Cancer"},{"issue":"7","key":"10.1016\/j.esmoop.2026.108369_bib32","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0042164","article-title":"Complex mutations & subpopulations of deletions at exon 19 of EGFR in NSCLC revealed by next generation sequencing: potential clinical implications","volume":"7","author":"Marchetti","year":"2012","journal-title":"PLoS One"},{"issue":"7","key":"10.1016\/j.esmoop.2026.108369_bib33","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1016\/j.annonc.2024.04.005","article-title":"Recommendations for the use of next-generation sequencing (NGS) for patients with advanced cancer in 2024: a report from the ESMO Precision Medicine Working Group","volume":"35","author":"Mosele","year":"2024","journal-title":"Ann Oncol"},{"issue":"7","key":"10.1016\/j.esmoop.2026.108369_bib34","first-page":"3647","article-title":"Targeted next-generation sequencing in cytology specimens for molecular profiling of lung adenocarcinoma","volume":"11","author":"Zhang","year":"2018","journal-title":"Int J Clin Exp Pathol"},{"issue":"17","key":"10.1016\/j.esmoop.2026.108369_bib35","doi-asserted-by":"crossref","first-page":"1681","DOI":"10.1056\/NEJMoa2503001","article-title":"Overall survival with amivantamab\u2013lazertinib in EGFR-mutated advanced NSCLC","volume":"393","author":"Yang","year":"2025","journal-title":"N Engl J Med"},{"key":"10.1016\/j.esmoop.2026.108369_bib36","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1056\/NEJMoa2510308","article-title":"Survival with osimertinib plus chemotherapy in EGFR-mutated advanced NSCLC","volume":"394","author":"J\u00e4nne","year":"2026","journal-title":"N Engl J Med"},{"issue":"11","key":"10.1016\/j.esmoop.2026.108369_bib37","doi-asserted-by":"crossref","first-page":"2123","DOI":"10.1158\/1078-0432.CCR-22-3497","article-title":"Efficacy of osimertinib in patients with lung cancer positive for uncommon EGFR exon 19 deletion mutations","volume":"29","author":"Grant","year":"2023","journal-title":"Clin Cancer Res"},{"issue":"9","key":"10.1016\/j.esmoop.2026.108369_bib38","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1016\/j.annonc.2024.05.541","article-title":"Amivantamab plus lazertinib versus osimertinib in first-line EGFR-mutant advanced non-small-cell lung cancer with biomarkers of high-risk disease: a secondary analysis from MARIPOSA","volume":"35","author":"Felip","year":"2024","journal-title":"Ann Oncol"},{"issue":"4","key":"10.1016\/j.esmoop.2026.108369_bib39","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1016\/j.annonc.2022.12.013","article-title":"Non-oncogene-addicted metastatic non-small-cell lung cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up","volume":"34","author":"Hendriks","year":"2023","journal-title":"Ann Oncol"},{"issue":"8","key":"10.1016\/j.esmoop.2026.108369_bib40","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1016\/j.annonc.2025.04.003","article-title":"Savolitinib plus osimertinib in epidermal growth factor receptor (EGFR)-mutated advanced non-small cell lung cancer with MET overexpression and\/or amplification following disease progression on osimertinib: primary results from the phase II SAVANNAH study","volume":"36","author":"de Marinis","year":"2025","journal-title":"Ann Oncol"},{"issue":"8","key":"10.1016\/j.esmoop.2026.108369_bib41","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1016\/S1470-2045(24)00270-5","article-title":"Tepotinib plus osimertinib in patients with EGFR-mutated non-small-cell lung cancer with MET amplification following progression on first-line osimertinib (INSIGHT 2): a multicentre, open-label, phase 2 trial","volume":"25","author":"Wu","year":"2024","journal-title":"Lancet Oncol"},{"issue":"2","key":"10.1016\/j.esmoop.2026.108369_bib42","article-title":"Overcoming resistance to osimertinib by T790M loss and C797S acquisition using gefitinib in a patient with EGFR-mutant NSCLC: a case report","volume":"4","author":"Enrico","year":"2023","journal-title":"JTO Clin Res Rep"},{"issue":"8","key":"10.1016\/j.esmoop.2026.108369_bib43","doi-asserted-by":"crossref","first-page":"5379","DOI":"10.21037\/jtd-23-629","article-title":"Efficacy and tolerability of osimertinib with dabrafenib and trametinib in BRAF V600E acquired EGFR-mutant non-small cell lung cancer: a case series","volume":"16","author":"Lu","year":"2024","journal-title":"J Thorac Dis"},{"issue":"19","key":"10.1016\/j.esmoop.2026.108369_bib44","doi-asserted-by":"crossref","first-page":"1814","DOI":"10.1056\/NEJMoa1510016","article-title":"Cabozantinib versus everolimus in advanced renal-cell carcinoma","volume":"373","author":"Choueiri","year":"2015","journal-title":"N Engl J Med"}],"container-title":["ESMO Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2059702926023124?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2059702926023124?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T23:42:18Z","timestamp":1792712538000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2059702926023124"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":44,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["S2059702926023124"],"URL":"https:\/\/doi.org\/10.1016\/j.esmoop.2026.108369","relation":{},"ISSN":["2059-7029"],"issn-type":[{"value":"2059-7029","type":"print"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Osimertinib in advanced non-small cell lung cancer (NSCLC) harboring different EGFR uncommon variants: real-world data from the Italian biomarker ATLAS database","name":"articletitle","label":"Article Title"},{"value":"ESMO Open","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.esmoop.2026.108369","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Author(s). Published by Elsevier Ltd on behalf of European Society for Medical Oncology.","name":"copyright","label":"Copyright"}],"article-number":"108369"}}