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5 m (95% CI12.7-16.3 m) vs. 30.3 m (95% CI not reached), p = 0.04], while the OS was comparable among three subtypes. For the response to afatinib, ERBB2ex20ins as a subclonal variant was an independent factor relating to shorter PFS [median PFS 1.2 m (95% CI 0.8-1.6 m) vs. 4.3 m (95% CI 3.3-5.3 m), p less then 0.05]. Conclusion Our data revealed co-occurring TP53 represent an unfavorable prognosis of patients with ERBB2ex20ins, emphasizing the more valuable role of the co-mutation patterns than insertion-site subtypes in predicting progn