Uncommon epidermal growth factor receptor (EGFR) mutations collectively account for 10% of EGFR mutations, harboring heterogeneous molecular alterations within exons 18-21 with clinically variable responses to EGFR tyrosine kinase inhibitors (TKIs) in advanced Non-Small Cell Lung Cancer (NSCLC) patients. In addition, with the introduction of different NGS gene approach an improvement of EGFR mutations detection was reported. Today, no specific studies have prospectively evaluated uncommon sensitizing mutations in detail and no firm standard of care has been established in the first-line setting. The aim of this comprehensive review is to critically consider the clinical role of uncommon EGFR mutations highlighting the results of several in vitro and in vivo studies, which singly evaluated the sensitivity of uncommon mutations to currently European of Medicines Agency (EMA)-approved EGFR TKIs in cell lines, xenograft models and humans, in order to obtain a practical guide for refining the clinical decision-making process.

中文翻译：

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非小细胞肺癌中表皮生长因子受体罕见突变的意义：系统评价和严格评估。

罕见的表皮生长因子受体（EGFR）突变共同占EGFR突变的10％，在外显子18-21内具有异质性分子变化，对晚期非小细胞肺癌（NSCLC）的EGFR酪氨酸激酶抑制剂（TKI）具有临床可变的反应耐心。另外，随着不同NGS基因方法的引入，报道了EGFR突变检测的改善。时至今日，尚无任何具体的研究可以对不常见的致敏突变进行详细的前瞻性评估，并且在一线治疗中还没有建立起严格的护理标准。这项全面审查的目的是严格考虑罕见的EGFR突变的临床作用，以突出一些体外和体内研究的结果，