{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T17:13:19Z","timestamp":1789146799968,"version":"build-2803163510"},"reference-count":42,"publisher":"Elsevier BV","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":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","lungcancerjournal.info","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Lung Cancer"],"published-print":{"date-parts":[[2026,10]]},"DOI":"10.1016\/j.lungcan.2026.109604","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T14:54:42Z","timestamp":1788188082000},"page":"109604","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["Clinical outcomes and genomic features of uncommon EGFR exon 19 deletion subtypes in osimertinib-treated non-small cell lung cancer"],"prefix":"10.1016","volume":"220","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5434-5459","authenticated-orcid":false,"given":"Hiroto","family":"Hatano","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4896-5824","authenticated-orcid":false,"given":"Tatsuya","family":"Yoshida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryoko Inaba","family":"Higashiyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masayuki","family":"Shirasawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5579-4491","authenticated-orcid":false,"given":"Yoshiro","family":"Nakahara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9637-1388","authenticated-orcid":false,"given":"Katsuhiko","family":"Naoki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Nokihara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kentaro","family":"Gosho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuji","family":"Uehara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3849-5905","authenticated-orcid":false,"given":"Yukio","family":"Hosomi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayu","family":"Kiritani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3729-1716","authenticated-orcid":false,"given":"Hiroshi","family":"Wakui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1813-4184","authenticated-orcid":false,"given":"Yuki","family":"Shinno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5743-0149","authenticated-orcid":false,"given":"Yusuke","family":"Okuma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidehito","family":"Horinouchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0787-2851","authenticated-orcid":false,"given":"Noboru","family":"Yamamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasushi","family":"Goto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.lungcan.2026.109604_b0005","doi-asserted-by":"crossref","first-page":"2380","DOI":"10.1056\/NEJMoa0909530","article-title":"Gefitinib or chemotherapy for non-small-cell lung cancer with mutated EGFR","volume":"362","author":"Maemondo","year":"2010","journal-title":"N. Engl. J. Med."},{"key":"10.1016\/j.lungcan.2026.109604_b0010","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1016\/S1470-2045(11)70393-X","article-title":"Erlotinib versus standard chemotherapy as first-line treatment for European patients with advanced EGFR mutation-positive non-small-cell lung cancer (EURTAC): a multicentre, open-label, randomised phase 3 trial","volume":"13","author":"Rosell","year":"2012","journal-title":"Lancet Oncol."},{"key":"10.1016\/j.lungcan.2026.109604_b0015","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1056\/NEJMoa1713137","article-title":"Osimertinib in untreated EGFR-mutated advanced non-small-cell lung cancer","volume":"378","author":"Soria","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"10.1016\/j.lungcan.2026.109604_b0020","article-title":"Real-world outcomes of treatment strategy between first-line osimertinib, first\/second-generation EGFR-TKIs followed by osimertinib and without osimertinib in advanced EGFR-mutant NSCLC","volume":"5","author":"Uehara","year":"2024","journal-title":"ESMO Real World Data Digital Oncol."},{"key":"10.1016\/j.lungcan.2026.109604_b0025","doi-asserted-by":"crossref","first-page":"1389","DOI":"10.1038\/nm.3388","article-title":"The quest to overcome resistance to EGFR-targeted therapies in cancer","volume":"19","author":"Chong","year":"2013","journal-title":"Nat. Med."},{"key":"10.1016\/j.lungcan.2026.109604_b0030","doi-asserted-by":"crossref","DOI":"10.3892\/ijo.2021.5270","article-title":"Mechanisms and management of 3rd\u2011generation EGFR\u2011TKI resistance in advanced non\u2011small cell lung cancer (review)","volume":"59","author":"He","year":"2021","journal-title":"Int. J. Oncol."},{"key":"10.1016\/j.lungcan.2026.109604_b0035","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."},{"key":"10.1016\/j.lungcan.2026.109604_b0040","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"},{"key":"10.1016\/j.lungcan.2026.109604_b0045","doi-asserted-by":"crossref","first-page":"3470","DOI":"10.1158\/1078-0432.CCR-11-2353","article-title":"Clinical outcomes in non-small cell lung cancers harboring different exon 19 deletions in EGFR","volume":"18","author":"Chung","year":"2012","journal-title":"Clin. Cancer Res."},{"key":"10.1016\/j.lungcan.2026.109604_b0050","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.lungcan.2014.09.014","article-title":"Possible differential EGFR-TKI efficacy among exon 19 deletional locations in EGFR-mutant non-small cell lung cancer","volume":"86","author":"Kaneda","year":"2014","journal-title":"Lung Cancer"},{"key":"10.1016\/j.lungcan.2026.109604_b0055","doi-asserted-by":"crossref","first-page":"1148","DOI":"10.1097\/JTO.0b013e31829f684a","article-title":"Association of exon 19 and 21 EGFR mutation patterns with treatment outcome after first-line tyrosine kinase inhibitor in metastatic non-small-cell lung cancer","volume":"8","author":"Lee","year":"2013","journal-title":"J. Thorac. Oncol."},{"key":"10.1016\/j.lungcan.2026.109604_b0060","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/j.jtho.2016.11.2225","article-title":"EGFR mutation subtypes influence survival outcomes following first-line gefitinib therapy in advanced Asian NSCLC patients","volume":"12","author":"Sutiman","year":"2017","journal-title":"J. Thorac. Oncol."},{"key":"10.1016\/j.lungcan.2026.109604_b0065","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1007\/s11523-020-00722-0","article-title":"Heterogeneous response to first-generation tyrosine kinase inhibitors in non-small-cell lung cancers with different EGFR Exon 19 mutations","volume":"15","author":"Xu","year":"2020","journal-title":"Target. Oncol."},{"key":"10.1016\/j.lungcan.2026.109604_b0070","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.21037\/tlcr-19-359","article-title":"The impact of EGFR exon 19 deletion subtypes on clinical outcomes in non-small cell lung cancer","volume":"9","author":"Zhao","year":"2020","journal-title":"Transl. Lung Cancer Res."},{"key":"10.1016\/j.lungcan.2026.109604_b0075","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/j.cllc.2018.10.009","article-title":"Impact of Exon 19 deletion subtypes in EGFR-mutant metastatic non-small-cell lung cancer treated with first-line tyrosine kinase inhibitors","volume":"20","author":"Rossi","year":"2019","journal-title":"Clin. Lung Cancer"},{"key":"10.1016\/j.lungcan.2026.109604_b0080","doi-asserted-by":"crossref","first-page":"111246","DOI":"10.18632\/oncotarget.22768","article-title":"Molecular characteristics and clinical outcomes of EGFR exon 19 indel subtypes to EGFR TKIs in NSCLC patients","volume":"8","author":"Su","year":"2017","journal-title":"Oncotarget"},{"key":"10.1016\/j.lungcan.2026.109604_b0085","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"},{"key":"10.1016\/j.lungcan.2026.109604_b0090","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1186\/s12885-021-08942-x","article-title":"Patients harboring uncommon EGFR exon 19 deletion-insertion mutations respond well to first-generation EGFR inhibitors and osimeritinib upon acquisition of T790M","volume":"21","author":"Wang","year":"2021","journal-title":"BMC Cancer"},{"key":"10.1016\/j.lungcan.2026.109604_b0095","doi-asserted-by":"crossref","DOI":"10.1016\/j.cllc.2025.03.008","article-title":"Brief report: the effectiveness of osimertinib in advanced nonsmall cell lung cancer harboring various EGFR Exon 19 mutation variants","volume":"26","author":"Chang","year":"2025","journal-title":"Clin. Lung Cancer"},{"key":"10.1016\/j.lungcan.2026.109604_b0100","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"},{"key":"10.1016\/j.lungcan.2026.109604_b0105","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"},{"key":"10.1016\/j.lungcan.2026.109604_b0110","article-title":"Structure-based classification for differential tyrosine kinase inhibitors efficacy of EGFR exon 19 deletions in non-small cell lung cancer","author":"Zhuang","year":"2026","journal-title":"Sci. China Life Sci."},{"key":"10.1016\/j.lungcan.2026.109604_b0115","doi-asserted-by":"crossref","first-page":"6417","DOI":"10.1038\/s41467-024-50882-0","article-title":"Harnessing DNA replication stress to target RBM10 deficiency in lung adenocarcinoma","volume":"15","author":"Machour","year":"2024","journal-title":"Nat. Commun."},{"key":"10.1016\/j.lungcan.2026.109604_b0120","doi-asserted-by":"crossref","first-page":"1490","DOI":"10.1158\/0008-5472.CAN-22-1549","article-title":"RBM10 loss promotes EGFR-driven lung cancer and confers sensitivity to spliceosome inhibition","volume":"83","author":"Bao","year":"2023","journal-title":"Cancer Res."},{"key":"10.1016\/j.lungcan.2026.109604_b0125","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/j.cell.2020.06.012","article-title":"Proteogenomics of non-smoking lung cancer in East Asia delineates molecular signatures of pathogenesis and progression","volume":"182","author":"Chen","year":"2020","journal-title":"Cell"},{"key":"10.1016\/j.lungcan.2026.109604_b0130","doi-asserted-by":"crossref","first-page":"1348","DOI":"10.1038\/s41588-021-00920-0","article-title":"Genomic and evolutionary classification of lung cancer in never smokers","volume":"53","author":"Zhang","year":"2021","journal-title":"Nat. Genet."},{"key":"10.1016\/j.lungcan.2026.109604_b0135","doi-asserted-by":"crossref","first-page":"e411","DOI":"10.1016\/j.cllc.2024.07.010","article-title":"RBM10 mutation as a potential negative prognostic\/predictive biomarker to therapy in non-small-cell lung cancer","volume":"25","author":"Reyes","year":"2024","journal-title":"Clin. Lung Cancer"},{"key":"10.1016\/j.lungcan.2026.109604_b0140","doi-asserted-by":"crossref","DOI":"10.1172\/JCI145099","article-title":"Deficiency of the splicing factor RBM10 limits EGFR inhibitor response in EGFR-mutant lung cancer","volume":"132","author":"Nanjo","year":"2022","journal-title":"J. Clin. Invest."},{"key":"10.1016\/j.lungcan.2026.109604_b0145","article-title":"Investigation of RBM10 mutation and its associations with clinical and molecular characteristics in EGFR-mutant and EGFR-wildtype lung adenocarcinoma","volume":"10","author":"Cao","year":"2024","journal-title":"Heliyon"},{"key":"10.1016\/j.lungcan.2026.109604_b0150","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."},{"key":"10.1016\/j.lungcan.2026.109604_b0155","article-title":"Distinct progression and efficacy of first-line osimertinib treatment according to mutation subtypes in metastatic NSCLC harboring EGFR mutations","volume":"5","author":"Takeyasu","year":"2024","journal-title":"JTO Clin. Res. Rep."},{"key":"10.1016\/j.lungcan.2026.109604_b0160","doi-asserted-by":"crossref","first-page":"2688","DOI":"10.1038\/bjc.2014.218","article-title":"Clinicopathologic and prognostic significance of c-MYC copy number gain in lung adenocarcinomas","volume":"110","author":"Seo","year":"2014","journal-title":"Br. J. Cancer"},{"key":"10.1016\/j.lungcan.2026.109604_b0165","doi-asserted-by":"crossref","first-page":"1481","DOI":"10.1158\/1078-0432.CCR-10-2484","article-title":"MYC amplification as a prognostic marker of early-stage lung adenocarcinoma identified by whole genome copy number analysis","volume":"17","author":"Iwakawa","year":"2011","journal-title":"Clin. Cancer Res."},{"key":"10.1016\/j.lungcan.2026.109604_b0170","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.lungcan.2016.10.015","article-title":"Coexistence of p16\/CDKN2A homozygous deletions and activating EGFR mutations in lung adenocarcinoma patients signifies a poor response to EGFR-TKIs","volume":"102","author":"Jiang","year":"2016","journal-title":"Lung Cancer"},{"key":"10.1016\/j.lungcan.2026.109604_b0175","doi-asserted-by":"crossref","first-page":"1746","DOI":"10.1002\/1878-0261.13206","article-title":"Co-occurrence of CDKN2A\/B and IFN-I homozygous deletions correlates with an immunosuppressive phenotype and poor prognosis in lung adenocarcinoma","volume":"16","author":"Peng","year":"2022","journal-title":"Mol. Oncol."},{"key":"10.1016\/j.lungcan.2026.109604_b0180","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."},{"key":"10.1016\/j.lungcan.2026.109604_b0185","doi-asserted-by":"crossref","first-page":"1935","DOI":"10.1056\/NEJMoa2306434","article-title":"Osimertinib with or without chemotherapy in EGFR-mutated advanced NSCLC","volume":"389","author":"Planchard","year":"2023","journal-title":"N. Engl. J. Med."},{"key":"10.1016\/j.lungcan.2026.109604_b0190","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."},{"key":"10.1016\/j.lungcan.2026.109604_b0195","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1186\/s13046-019-1240-x","article-title":"Third generation EGFR inhibitor osimertinib combined with pemetrexed or cisplatin exerts long-lasting anti-tumor effect in EGFR-mutated pre-clinical models of NSCLC","volume":"38","author":"La Monica","year":"2019","journal-title":"J. Exp. Clin. Cancer Res."},{"key":"10.1016\/j.lungcan.2026.109604_b0200","doi-asserted-by":"crossref","first-page":"1486","DOI":"10.1056\/NEJMoa2403614","article-title":"Amivantamab plus lazertinib in previously untreated EGFR-mutated advanced NSCLC","volume":"391","author":"Cho","year":"2024","journal-title":"N. Engl. J. Med."},{"key":"10.1016\/j.lungcan.2026.109604_b0205","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 - mechanisms and evolving treatment approaches","volume":"23","author":"Zhao","year":"2026","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"10.1016\/j.lungcan.2026.109604_b0210","doi-asserted-by":"crossref","DOI":"10.1080\/14756366.2025.2481392","article-title":"Fourth-generation EGFR-TKI to overcome C797S mutation: past, present, and future","volume":"40","author":"Zhang","year":"2025","journal-title":"J. Enzyme Inhib. Med. Chem."}],"container-title":["Lung Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0169500226006653?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0169500226006653?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T16:53:29Z","timestamp":1789145609000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0169500226006653"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":42,"alternative-id":["S0169500226006653"],"URL":"https:\/\/doi.org\/10.1016\/j.lungcan.2026.109604","relation":{},"ISSN":["0169-5002"],"issn-type":[{"value":"0169-5002","type":"print"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Clinical outcomes and genomic features of uncommon EGFR exon 19 deletion subtypes in osimertinib-treated non-small cell lung cancer","name":"articletitle","label":"Article Title"},{"value":"Lung Cancer","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.lungcan.2026.109604","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}],"article-number":"109604"}}