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    1. A Nationwide Study on the Impact of Routine Testing for EGFR Mutations in Advanced NSCLC Reveals Distinct Survival Patterns Based on EGFR Mutation Subclasses

      [Paper-level Aggregated] PMCID: PMC8307492

      Evidence Type(s): Predictive, Prognostic, Oncogenic

      Justification: Predictive: The text discusses the association of specific EGFR mutations, such as L858R and exon 19 deletions, with overall survival (OS) outcomes in patients treated with first-line EGFR inhibitors, indicating their predictive value for treatment response. Prognostic: The analysis of overall survival (OS) based on different EGFR mutation subclasses, including L858R and uncommon actionable variants, demonstrates their prognostic significance in determining patient outcomes. Oncogenic: The presence of EGFR mutations, including L858R and T790M, is associated with non-small-cell lung cancer (NSCLC), indicating their role in oncogenesis.

      Gene→Variant (gene-first): EGFR(1956):G719S EGFR(1956):L858R EGFR(1956):L861Q EGFR(1956):T790M EGFR(1956):L861X

      Genes: EGFR(1956)

      Variants: G719S L858R L861Q T790M L861X

    2. In 2017, the third-generation EGFR inhibitor osimertinib was approved for use in patients who developed the EGFR T790M mutation as a mechanism of resistance. In this year, of the 254 patients who received an EGFR inhibit

      [Paragraph-level] PMCID: PMC8307492 Section: RESULTS PassageIndex: 18

      Evidence Type(s): Predictive, Oncogenic

      Justification: Predictive: The passage discusses the T790M mutation as a mechanism of resistance to the EGFR inhibitor osimertinib, indicating its correlation with treatment response. Oncogenic: The T790M mutation is described as contributing to resistance in patients treated with EGFR inhibitors, suggesting its role in tumor progression.

      Gene→Variant (gene-first): 1956:G719S 1956:L858R 1956:L861Q 1956:T790M

      Genes: 1956

      Variants: G719S L858R L861Q T790M

    3. Uni- and multivariable Cox regression analyses were performed to evaluate whether the type of EGFR mutation is associated with OS (Table 3). Because OS for patients with EGFR exon 20 insertions and patients with not acti

      [Paragraph-level] PMCID: PMC8307492 Section: RESULTS PassageIndex: 17

      Evidence Type(s): Prognostic, Diagnostic

      Justification: Prognostic: The passage discusses overall survival (OS) outcomes associated with the L858R variant, indicating that it correlates with disease outcome independent of therapy. Diagnostic: The mention of the type of EGFR mutation, including L858R, being associated with overall survival suggests its role in classifying or defining disease outcomes.

      Gene→Variant (gene-first): 1956:L858R

      Genes: 1956

      Variants: L858R

    4. The proportion of patients receiving first-line targeted therapy was highest for those with an exon 19 deletion (321/390; 82%) or L858R mutation (227/287; 79%), lower for those with uncommon, actionable variants (69/103;

      [Paragraph-level] PMCID: PMC8307492 Section: RESULTS PassageIndex: 16

      Evidence Type(s): Predictive, Prognostic

      Justification: Predictive: The passage discusses the proportion of patients receiving first-line targeted therapy based on the presence of the L858R mutation, indicating a correlation with treatment response. Prognostic: The median overall survival (OS) for patients with the L858R mutation is reported, demonstrating its correlation with disease outcome independent of therapy.

      Gene→Variant (gene-first): 1956:L858R

      Genes: 1956

      Variants: L858R

    5. OS in patients with any EGFR mutation was higher for those diagnosed in 2017 (median 18.1 months; 95% CI, 15.7-20.5) compared to 2013 (median 14.3 months; 95% CI, 12.5-16.1; p = 0.035), but similar to 2015 (median 17.6 m

      [Paragraph-level] PMCID: PMC8307492 Section: RESULTS PassageIndex: 13

      Evidence Type(s): Prognostic, Diagnostic

      Justification: Prognostic: The passage discusses overall survival (OS) in patients with the L858R variant, indicating a correlation between this variant and disease outcome, independent of therapy. Diagnostic: The mention of distinct survival patterns observed in different EGFR mutation subclasses, including L858R, suggests that this variant is used to classify or define a subtype of disease.

      Gene→Variant (gene-first): 1956:L858R

      Genes: 1956

      Variants: L858R

    6. Treatment and survival data were available for 10,237 out of 10,254 patients (99.8%). This included 390 patients with an exon 19 deletion, 287 patients with L858R, 103 patients with an uncommon, actionable variant, 69 pa

      [Paragraph-level] PMCID: PMC8307492 Section: RESULTS PassageIndex: 11

      Evidence Type(s): None

      Justification: Not enough information in this passage.

      Gene→Variant (gene-first): 1956:L858R

      Genes: 1956

      Variants: L858R

    7. Of the 7908 patients tested for EGFR mutations at initial diagnosis, one or more mutations were reported in 11.7% of all cases (95% CI, 11.0-12.4%; n = 925) (Table 2). Female patients were more likely to harbor EGFR muta

      [Paragraph-level] PMCID: PMC8307492 Section: RESULTS PassageIndex: 9

      Evidence Type(s): Diagnostic, Oncogenic

      Justification: Diagnostic: The passage discusses the prevalence of EGFR mutations, including L858R and L861X, in patients at initial diagnosis, indicating their association with the disease and their use in defining the mutation status of patients. Oncogenic: The variants L858R and L861X are described as actionable mutations within the context of EGFR, suggesting their role in tumor development or progression.

      Gene→Variant (gene-first): 1956:L858R 1956:L861X

      Genes: 1956

      Variants: L858R L861X

    8. EGFR mutation analysis in non-small-cell lung cancer (NSCLC) patients is currently standard-of-care. We determined the uptake of EGFR testing, test results and survival of EGFR-mutant NSCLC patients in the Netherlands, w

      [Paragraph-level] PMCID: PMC8307492 Section: ABSTRACT PassageIndex: 4

      Evidence Type(s): Predictive, Oncogenic

      Justification: Predictive: The passage discusses the association of the L858R variant with overall survival (OS) in patients treated with first-line EGFR inhibitors, indicating its relevance to treatment response. Oncogenic: The L858R variant is mentioned in the context of EGFR mutations in non-small-cell lung cancer (NSCLC), suggesting its role in tumor development or progression as part of the broader analysis of clinically actionable EGFR mutations.

      Gene→Variant (gene-first): 1956:L858R

      Genes: 1956

      Variants: L858R

    9. In 2017, the third-generation EGFR inhibitor osimertinib was approved for use in patients who developed the EGFR T790M mutation as a mechanism of resistance. In this year, of the 254 patients who received an EGFR inhibit

      [Paragraph-level] PMCID: PMC8307492 Section: RESULTS PassageIndex: 18

      Evidence Type(s): Predictive, Oncogenic

      Justification: Predictive: The passage discusses the T790M mutation as a mechanism of resistance to the EGFR inhibitor osimertinib, indicating its correlation with treatment response. Oncogenic: The T790M mutation is described as contributing to resistance in patients treated with EGFR inhibitors, suggesting its role in tumor progression.

      Gene→Variant (gene-first): 1956:G719S 1956:L858R 1956:L861Q 1956:T790M

      Genes: 1956

      Variants: G719S L858R L861Q T790M

    10. Uni- and multivariable Cox regression analyses were performed to evaluate whether the type of EGFR mutation is associated with OS (Table 3). Because OS for patients with EGFR exon 20 insertions and patients with not acti

      [Paragraph-level] PMCID: PMC8307492 Section: RESULTS PassageIndex: 17

      Evidence Type(s): Prognostic, Diagnostic

      Justification: Prognostic: The passage discusses overall survival (OS) outcomes associated with the L858R variant, indicating that it correlates with disease outcome independent of therapy. Diagnostic: The mention of the type of EGFR mutation, including L858R, being associated with overall survival suggests its role in classifying or defining disease outcomes.

      Gene→Variant (gene-first): 1956:L858R

      Genes: 1956

      Variants: L858R

    11. The proportion of patients receiving first-line targeted therapy was highest for those with an exon 19 deletion (321/390; 82%) or L858R mutation (227/287; 79%), lower for those with uncommon, actionable variants (69/103;

      [Paragraph-level] PMCID: PMC8307492 Section: RESULTS PassageIndex: 16

      Evidence Type(s): Predictive, Prognostic

      Justification: Predictive: The passage discusses the proportion of patients receiving first-line targeted therapy based on the presence of the L858R mutation, indicating a correlation with treatment response. Prognostic: The median overall survival (OS) for patients with the L858R mutation is reported, demonstrating its correlation with disease outcome independent of therapy.

      Gene→Variant (gene-first): 1956:L858R

      Genes: 1956

      Variants: L858R

    12. OS in patients with any EGFR mutation was higher for those diagnosed in 2017 (median 18.1 months; 95% CI, 15.7-20.5) compared to 2013 (median 14.3 months; 95% CI, 12.5-16.1; p = 0.035), but similar to 2015 (median 17.6 m

      [Paragraph-level] PMCID: PMC8307492 Section: RESULTS PassageIndex: 13

      Evidence Type(s): Prognostic, Diagnostic

      Justification: Prognostic: The passage discusses overall survival (OS) in patients with the L858R variant, indicating a correlation between this variant and disease outcome, independent of therapy. Diagnostic: The mention of distinct survival patterns observed in different EGFR mutation subclasses, including L858R, suggests that this variant is used to classify or define a subtype of disease.

      Gene→Variant (gene-first): 1956:L858R

      Genes: 1956

      Variants: L858R

    13. Treatment and survival data were available for 10,237 out of 10,254 patients (99.8%). This included 390 patients with an exon 19 deletion, 287 patients with L858R, 103 patients with an uncommon, actionable variant, 69 pa

      [Paragraph-level] PMCID: PMC8307492 Section: RESULTS PassageIndex: 11

      Evidence Type(s): None

      Justification: Not enough information in this passage.

      Gene→Variant (gene-first): 1956:L858R

      Genes: 1956

      Variants: L858R

    14. Of the 7908 patients tested for EGFR mutations at initial diagnosis, one or more mutations were reported in 11.7% of all cases (95% CI, 11.0-12.4%; n = 925) (Table 2). Female patients were more likely to harbor EGFR muta

      [Paragraph-level] PMCID: PMC8307492 Section: RESULTS PassageIndex: 9

      Evidence Type(s): Diagnostic, Oncogenic

      Justification: Diagnostic: The passage discusses the prevalence of EGFR mutations, including L858R and L861X, in patients at initial diagnosis, indicating their association with the disease and their use in defining the mutation status of patients. Oncogenic: The variants L858R and L861X are described as actionable mutations within the context of EGFR, suggesting their role in tumor development or progression.

      Gene→Variant (gene-first): 1956:L858R 1956:L861X

      Genes: 1956

      Variants: L858R L861X

    15. EGFR mutation analysis in non-small-cell lung cancer (NSCLC) patients is currently standard-of-care. We determined the uptake of EGFR testing, test results and survival of EGFR-mutant NSCLC patients in the Netherlands, w

      [Paragraph-level] PMCID: PMC8307492 Section: ABSTRACT PassageIndex: 4

      Evidence Type(s): Predictive, Oncogenic

      Justification: Predictive: The passage discusses the association of the L858R variant with overall survival (OS) in patients treated with first-line EGFR inhibitors, indicating its relevance to treatment response. Oncogenic: The L858R variant is mentioned in the context of EGFR mutations in non-small-cell lung cancer (NSCLC), suggesting its role in tumor development or progression as part of the broader analysis of clinically actionable EGFR mutations.

      Gene→Variant (gene-first): 1956:L858R

      Genes: 1956

      Variants: L858R