A lung adenocarcinoma with rare epidermal growth factor receptor exon 20 V774M mutation was sensitive to osimertinib: A case report and molecular structural analysis

Epidermal growth factor receptor (EGFR) mutations are the most common driver mutations in non-small cell lung cancer (NSCLC). EGFR tyrosine kinase inhibitors (EGFR-TKIs) have remarkably improved the prognosis of patients with classical activating mutations (EGFR exon 19 deletion and L858R mutations), but the efficacy of EGFR-TKIs in rare EGFR mutations remains heterogeneous and controversial [1]. Herein, we describe a NSCLC patient with a rare EGFR V774M mutation was sensitive to osimertinib. We also predict the protein structure of EGFR V774M mutation and evaluate the binding ability of different EGFR-TKIs to V774M conformation via in silico analysis.