CHIH-HSIN YANGWang, MengzhaoMengzhaoWangDoucet, LudovicLudovicDoucetFan, YunYunFanLv, DongqingDongqingLvSun, MeiliMeiliSunHuang, DingzhiDingzhiHuangGreillier, LaurentLaurentGreillierPlanchard, DavidDavidPlanchardHong, QunyingQunyingHongMazieres, JulienJulienMazieresFelip, EnriquetaEnriquetaFelipLi, XingyaXingyaLiHu, YingYingHuFang, JianJianFangBazhenova, LyudmilaLyudmilaBazhenovaGhiringhelli, FrançoisFrançoisGhiringhelliCobo Dols, Manuel AngelManuel AngelCobo DolsRodriguez, Luis Paz-AresLuis Paz-AresRodriguezBearz, AlessandraAlessandraBearzPellini, BrunaBrunaPelliniKim, Yu JungYu JungKimBosch-Barrera, JoaquimJoaquimBosch-BarreraShim, Byoung-YongByoung-YongShimLuo, Yung-HungYung-HungLuoTiseo, MarcelloMarcelloTiseoYang, Tsung-YingTsung-YingYangCarcereny, EnricEnricCarcerenyMemmott, Regan MRegan MMemmottZalcman, GerardGerardZalcmande Castro Carpeno, JavierJavierde Castro CarpenoDi Noia, VincenzoVincenzoDi NoiaParra, Hector SotoHector SotoParraStreich, GuillermoGuillermoStreichLee, Dae HoDae HoLeeShum, ElaineElaineShumHan, Ji-YounJi-YounHanJaime, Jesus CorralJesus CorralJaimeBrungs, DanielDanielBrungsJohn, ThomasThomasJohnD'Arcangelo, ManoloManoloD'ArcangeloJoaquin, Andres BarbaAndres BarbaJoaquinLiu, GeoffreyGeoffreyLiuAntonuzzo, LorenzoLorenzoAntonuzzoHinojal, Gonzalo FernándezGonzalo FernándezHinojalLe, XiuningXiuningLeZheng, LiLiZhengJänne, Pasi APasi AJänne2026-01-092026-01-092025-10-10https://scholars.lib.ntu.edu.tw/handle/123456789/735213WU-KONG1B (ClinicalTrials.gov identifier: NCT03974022) is a multinational phase II, dose-randomized study to assess the antitumor efficacy of sunvozertinib in pretreated patients with advanced non-small cell lung cancer (NSCLC) with epidermal growth factor receptor () exon 20 insertion mutations (exon20ins).Eligible patients with advanced-stage exon20ins NSCLC were randomly assigned by 1:1 ratio to receive sunvozertinib 200 mg or 300 mg once daily (200 and 300 mg-rand cohorts). After predefined interim analysis, additional patients were enrolled and treated with the 300 mg dose once daily. The primary end point was blinded independent review committee (IRC)-assessed confirmed objective response rate (cORR), and the key secondary end point was duration of response (DoR).Among 85, 89, and 107 efficacy-evaluable patients in 200 mg-rand, 300 mg-rand, and 300 mg-all (including randomly assigned and nonrandomized patients) cohorts, the cORRs were 45.9% (97.5% CI, 33.6% to 58.5%), 47.2% (97.5% CI, 35.1% to 59.5%), and 45.8% (97.5% CI, 34.8% to 57.0%), respectively, per IRC assessment. The predefined null hypothesis was rejected with statistical significance ( < .0001). Comparing 300 and 200 mg-rand cohorts, higher cORRs were observed in patients with baseline brain metastasis (52.4% 28.6%) and previous amivantamab treatment (41.7% 25%), as well as longer DoR (13.8 11.1 months). At 200 and 300 mg once daily, the most common treatment-related adverse events with grade ≥3 included diarrhea (2.2% 18%), blood creatine phosphokinase increased (6.6% 12.6%), and anemia (4.4% 6.3%).Sunvozertinib is efficacious at both 200 and 300 mg once daily in treating platinum-pretreated patients with advanced exon20ins NSCLC. The treatment-related adverse events of sunvozertinib were consistent with an EGFR tyrosine kinase inhibitor, with a more favorable safety profile at 200 mg than 300 mg once daily.en[SDGs]SDG3journal article10.1200/JCO-25-0078840923280