ClinicalTrials.gg
Not yet recruitingNCT07458919Updated Mar 9, 2026

Therapy for Advanced NSCLC With EGFR 19delins Mutation

An Early Phase 1 interventional study of Icotinib/Gefitinib in Lung Cancer, sponsored by Fuzhou General Hospital. Not yet recruiting. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-03-09.

Sponsored by Fuzhou General Hospital · Early Phase 1, Interventional, and Treatment

Phase
Early Phase 1
Study type
Interventional
Enrollment
94
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

In a retrospective analysis of 3,054 advanced NSCLC patients, 41 with EGFR exon 19 deletion-insertions (19delins) received first-generation EGFR TKIs, achieving median PFS of 10.4 months; those with L747_T751delinsP had notably longer PFS of 18.7 months. Another study of 2,467 treatment-naïve patients found 93 with 19delins treated with first-generation TKIs had median PFS of 19 months, exceeding the 13 months for common 19del mutations. For third-generation TKIs, a study of 215 19delins patients (57 first-line) showed median PFS of 12.9 months, inferior to 23.2 months for common 19del. Our center's retrospective study of 4,666 NSCLC patients in Fujian (2017-2020) included 69 with 19delins: median PFS was 16.7 months with first-generation TKIs versus 7.2 months with third-generation. Evidence suggests specific EGFR deletion locations may affect TKI efficacy; first-generation TKIs may be superior in some 19delins subtypes, while third-generation appear limited. Large prospective data are lacking. This project aims to compare first- versus third-generation EGFR TKIs in 19delins patients via a randomized controlled trial, stratify sensitivity by subtype, and improve survival.

Read the detailed description

In a retrospective analysis of 3,054 patients with advanced non-small cell lung cancer (NSCLC), a total of 41 patients with EGFR exon 19 deletion-insertion mutations (19delins) were enrolled, all of whom received first-generation EGFR TKIs. The results showed a median progression-free survival (PFS) of 10.4 months, among which patients with L747_T751delinsP had a median PFS of 18.7 months, which appeared superior to that of patients with other 19delins mutations.

Another retrospective study analyzed 2,467 treatment-naïve patients with locally advanced NSCLC, among whom 93 patients with EGFR exon 19delins mutations were treated with first-generation EGFR TKIs (gefitinib, erlotinib). The median PFS was 19 months in patients with EGFR 19delins mutations, which was longer than that (13 months) in patients with common EGFR 19del mutations treated with first-generation EGFR TKIs during the same period.

However, regarding third-generation EGFR TKIs, a retrospective study enrolled 215 patients with EGFR 19delins mutations, including 57 patients treated with third-generation EGFR TKIs (osimertinib, furmonertinib, aumolertinib) as first-line therapy. The median PFS reached 12.9 months, which was lower than that (23.2 months) in patients with common EGFR 19del mutations.

This result is consistent with our center's previously published findings. A retrospective study of 4,666 NSCLC patients with EGFR mutations in Fujian Province from January 2017 to December 2020 included 69 patients with the EGFR exon 19delins subtype. The median PFS was 16.653 months in patients receiving first-generation EGFR TKIs and 7.179 months in those receiving third-generation EGFR TKIs.

Collectively, available evidence suggests that the specific location and structural variation type of EGFR deletions may affect the efficacy of different generations of TKIs. Especially for rare mutations such as 19delins, first-generation TKIs may show better efficacy in certain subtypes, while the efficacy of third-generation TKIs is relatively limited.

At present, large-scale prospective clinical data are still lacking for this type of mutation, and the optimal targeted therapeutic strategy remains to be further explored.

This project aims to clarify the efficacy and safety of first-generation versus third-generation EGFR TKIs in patients with EGFR exon 19delins mutations through a prospective, randomized controlled trial, further stratify the sensitivity of EGFR TKIs in patients with different EGFR mutation subtypes, and achieve longer survival benefits.

02

Conditions studied

  • Lung Cancer

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03

In context

Lung Neoplasms

5,422 studies on the registry are indexed under Lung Neoplasms; 1,346 are open to participants now.

This study's planned enrollment of 94 is above the median of 60 across 3,656 interventional studies indexed under Lung Neoplasms.

Browse Lung Neoplasms studies →

Lead sponsor

Fuzhou General Hospital is the lead sponsor of 40 studies on the registry; 9 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Age ≥ 18 years;
  • or cytologically confirmed locally advanced or non-small cell lung cancer (NSCLC) (AJCC Cancer Staging Manual, 9th edition, Stage IIIB, IIIC or IV) that is not amenable or suitable for surgical resection or other radical therapies, as assessed by the investigator;
  • Epidermal growth factor receptor (EGFR) exon 19 deletion-insertion mutation (19delins) documented by testing of tumor tissue or plasma samples using methods including IHC, NGS, ARMS, etc.;
  • (ECOG) performance status (PS) score of 0-1;
  • No prior systemic anti-tumor therapy for locally advanced or metastatic NSCLC;
  • ≥ 12 months;
  • At least one by imaging in the screening period according to v1.1;
  • Ability to swallow and retain oral medication;
  • Adequate organ system function;
  • Female subjects of must have a negative serum pregnancy test within 7 days prior to initiation of study treatment, and agree to use a medically accepted highly effective method of during the study and for 3 months after the last dose of study drug;
  • Voluntary and able to comply with study and follow-up procedures; Ability to understand the nature of the trial and provide written .

Exclusion criteria

Exclusion Criteria:

  • Advanced and/or symptomatic (measurable or non-measurable) and/or ;
  • Active , positive for virus antibody, positive for (HIV) antibody, or positive for Treponema pallidum antibody;
  • Women of with a positive serum pregnancy test within 7 days prior to initiation of treatment, pregnant or lactating women, or male and female subjects who are not using effective or plan to conceive during the entire treatment period and for 3 months after the end of treatment;
  • Patients who have used any of the following medications within 14 days prior to the first dose or require concomitant use of such medications during treatment: drugs with a risk of causing prolongation and/or torsade de pointes; strong inhibitors or strong inducers of ;
  • Underwent major surgery or immunotherapy within 4 weeks prior to the first dose; received radiation therapy within 2 weeks prior to the first dose;
  • Patients with imaging evidence of tumor invasion of major blood vessels, or those judged to have a very high likelihood of tumor invasion of critical blood vessels leading to fatal massive hemorrhage during the subsequent study period;
  • History of interstitial lung disease, drug-induced interstitial disease, or any clinically evident active interstitial lung disease; presence of idiopathic pulmonary fibrosis on baseline CT scan;
  • Other severe, acute, or chronic medical conditions that, in the investigator's opinion, may increase the risk associated with study participation or may interfere with the interpretation of study results, including uncontrolled diabetes mellitus, medical or psychiatric illnesses, or laboratory abnormalities;
  • Any other conditions deemed by the investigator to make the subject unsuitable for participation in this trial.
Terms in these criteria, in plain language(16)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

Measurable disease

The amount of disease can be tracked with a defined measurement, so the study can see whether it shrinks or grows. It might be a tumour measured on a scan or, in some blood cancers such as myeloma, a marker measured in blood or urine.

The criteria or the study team say which measurement counts — having no tumour visible on a scan does not by itself rule you out.

RECIST

The standard rules for measuring tumours on CT or MRI scans, to tell whether a cancer is shrinking, stable or growing during treatment.

“Measurable disease per RECIST 1.1” usually means at least one tumour 10 mm or more at its longest on a CT scan, or a lymph node 15 mm or more across its short axis.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Brain metastases

Cancer deposits in the brain from a cancer that started elsewhere in the body (CNS metastases include the spinal cord).

Studies differ: some leave out any brain metastases, some accept ones treated and stable for some weeks. Check what this study allows.

Leptomeningeal disease

Cancer that has spread to the leptomeninges, the thin layers covering the brain and spinal cord, and the fluid between them. It is not the same as brain metastases.

Criteria often treat it separately, and many studies leave it out even where treated brain metastases are allowed.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

QT and QTc

On an ECG, the QT interval is the time the heart’s lower chambers take to activate electrically and recover in each beat. QTc is that time adjusted for heart rate (QTcF by Fridericia’s formula, QTcB by Bazett’s). Some medicines lengthen it, and a long QTc can raise the risk of a dangerous heart rhythm.

The study may name a correction formula and a limit in milliseconds, often around 450–480.

CYP3A (CYP3A4) inhibitors and inducers

CYP3A is a group of enzymes, mainly CYP3A4, in the liver and gut that break down many medicines. Some medicines, supplements and foods (grapefruit, St John’s wort) slow them down or speed them up, which changes how much of a study drug stays in the body.

Studies list them so they can be avoided or switched; bring a list of everything you take, including supplements.

05

Study design

Phase
Early Phase 1
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Investigator, Outcomes assessor)
Enrollment
94 participants (estimated)

Study arms

  • Experimental
    Experimental group

    First-generation EGFR TKIs, including but not limited to: Icotinib: 125 mg per dose, three times daily Gefitinib: 250 mg per dose, once daily Administration shall be discontinued in case of tumor recurrence or intolerable toxicities during the treatment period.

    Drug: Icotinib/Gefitinib

  • Other
    Control group

    Third-generation EGFR TKIs, including but not limited to: Befotertinib: Oral administration, taken on an empty stomach or with food. 75 mg once daily (QD), 21 days per cycle. After one cycle of treatment, the dose shall be escalated to 100 mg QD if no CTCAE 5.0 grade ≥2 thrombocytopenia or headache occurs; otherwise, 75 mg QD shall be maintained. Osimertinib: 80 mg per dose, once daily Furmonertinib: 80 mg per dose, once daily Administration shall be discontinued in case of tumor recurrence or intolerable toxicities during the treatment period.

    Drug: Icotinib/Gefitinib

Interventions

  • DrugIcotinib/Gefitinib

    Drug pages: Icotinib · Gefitinib

    To explore the efficacy of first-generation EGFR TKIs versus third-generation EGFR TKIs in the first-line treatment of advanced NSCLC with EGFR 19delins mutation.

    Also known as: Befotertinib/Osimertinib/Furmonertinib

This study also gives Osimertinib. No intervention listed here names it: that was found by reading the record.

06

What researchers measure

Primary outcomes

  1. PFS

    Progression Free Survival

    Time frame: From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 60 months.

Secondary outcomes

  1. OS

    Overall Survival

    Time frame: From date of randomization until the date of death from any cause, assessed up to 60 months.

07

Study locations

No study locations are listed for this record.

08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Mar 9, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07458919
Lead sponsor
Fuzhou General Hospital
Responsible party
Sponsor
First posted
Mar 9, 2026
Start date
Mar 30, 2026 (estimated)
Primary completion
Oct 30, 2030 (estimated)
Completion
Oct 30, 2030 (estimated)
Last update
Mar 9, 2026

Study contacts

Yu Zongyang, PhD
Contact
hxkyzy2024@163.com
13509327806
Yu Zongyang, PhD
study director · The 900th Hospital of Joint Logistic Support Force PLA

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is not yet recruiting, as verified in Mar 2026. You cannot join it, but the record below documents what was studied.

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Discussion

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Studies of the drugs tested here: Icotinib · Gefitinib

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