Hard Search Map：EGFR L858R + TP53/RB1 + 骨转移 + 后奥希替尼路线图
类型: CCL 研究地图 / 搜索策略 发表日期: 2026-05-21 入库日期: 2026-05-21 来源: PubMed, FDA, ClinicalTrials.gov, CCL cross-reference 标签: EGFR L858R, 奥希替尼后, TP53, RB1, 小细胞转化, ADC, MET扩增, 骨转移, 寡进展
Case-specific search axes
Lineage transformation risk
- EGFR + RB1 + TP53
- NSE/ProGRP movement
- biopsy with neuroendocrine markers
Post-osimertinib resistance
- MET amplification
- EGFR C797S/T790M
- HER2/BRAF/PIK3CA/fusions
- histologic transformation
Later-line systemic therapy
- amivantamab + carboplatin/pemetrexed
- HER3-DXd / patritumab deruxtecan
- TROP2 ADC / datopotamab deruxtecan
- biomarker-directed ORCHARD-style trials
Local disease control
- oligoprogression radiation
- sternum/parasternal lesion biopsy + local treatment
- bone lesion fracture/SRE prevention
Supportive and safety
- denosumab, calcium/vitamin D, dental monitoring
- marrow suppression and cumulative platinum/pemetrexed toxicity
- QTc/echo monitoring with osimertinib
High-yield search strings for daily agent
"EGFR L858R" "RB1" "TP53" "small cell transformation""EGFR-mutant" osimertinib progression "small cell transformation" DLL3"EGFR-mutated NSCLC" "patritumab deruxtecan" HERTHENA"EGFR-mutated NSCLC" "datopotamab deruxtecan" TROPION"EGFR-mutant" osimertinib oligoprogression radiation"EGFR-mutated NSCLC" bone metastases denosumab osimertinib"MET amplification" osimertinib tepotinib savolitinib EGFR
Current CCL additions from this search
- Original RB1/TP53 transformation-risk paper
- TP53 resistance-evolution paper
- 2025 transformed-SCLC treatment outcomes paper
- DLL3/tarlatamab transformed-EGFR exploration
- HERTHENA-Lung01 HER3-DXd
- Dato-DXd FDA/TROP2 ADC update
- TROPION-Lung15 clinical-trial watch
- Oligoprogression LAT/osimertinib rechallenge
- Radiation for oligoprogression on osimertinib
- Consolidative RT with osimertinib
- Denosumab/bone-metastasis support
- EGFR bone metastases/SRE studies
- FLAURA2 overall-survival update
- Asia/China third-generation EGFR TKI context