Objectives: This study aimed to evaluate andamertinib, a selective and irreversible tyrosine kinase inhibitor, in pretreated advanced EGFR exon 20 insertion (ex20ins)-mutant NSCLC. Methods: In the phase 2, multicenter, single-arm KANNON study (NCT06015503), patients with locally advanced or metastatic NSCLC harboring EGFR ex20ins mutations who had progressed after platinum-based chemotherapy or immunotherapy received oral andamertinib 240 mg once daily in 28-day cycles. The primary end point was the confirmed objective response rate (ORR) assessed by independent review. Results: A total of 92 patients were enrolled and received daily 240 mg andamertinib, with nearly 30 different exo-n20ins subtypes included. The confirmed ORR was 42.7% (95% confidence interval [CI], 32.4-53.0), with a disease control rate of 86.5% and a median duration of response of 8.7 months (95% CI, 5.65-11.96). As of September 6, 2025, with a median follow-up of 15.4 (range, 0.4-20.5) months, the median progression-free survival was 6.2 months (95% CI, 4.63-7.85) and median overall survival was not reached (95% CI, 13.93 mo to not estimable), with a 12-month survival rate of 70.5%. Among 38 patients with brain metastasis, the systemic confirmed ORR was 47.4% (95% CI, 31.5-63.2). Grade more than or equal to 3 treatment-related adverse events occurred in 40.2% of patients, and the most frequent events were diarrhea (12.0%) and rash (7.6%). No interstitial lung disease or grade more than or equal to 3 QT prolongation was reported. Conclusions: Andamertinib at 240 mg once daily demonstrated efficacy with a manageable safety profile in previously treated patients with EGFR ex20ins-mutant NSCLC. (c) 2025 The Author(s). Published by Elsevier Inc. on behalf of International Association for the Study of Lung Cancer. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).