Consensus on the lung cancer management after third-generation EGFR-TKI resistance

Lancet Reg Health West Pac. 2024 Dec 11:53:101260. doi: 10.1016/j.lanwpc.2024.101260. eCollection 2024 Dec.

Abstract

Lung cancer is the most prevalent malignant tumour in the Asia-Pacific region. Non-small cell lung cancer (NSCLC) accounts for approximately 85% of lung cancers. Among these, the rate of EGFR mutations in Asian patients with lung adenocarcinoma is 40-60%. Third-generation EGFR tyrosine kinase inhibitors (EGFR-TKIs) have improved the clinical management of NSCLC with EGFR mutations, but resistance to these drugs remains a significant challenge. Despite numerous ongoing studies, there is no standardized consensus on managing resistance to third-generation EGFR-TKIs. This consensus integrates international guidelines on EGFR-TKI management, findings from clinical studies, and experiences from the Asia-Pacific region in addressing post-resistance. Detailed recommendations are provided for classification and progression patterns, clinical testing, and post-resistance treatment strategies related to third-generation EGFR-TKI resistance. The aim of these recommendations is to offer reference opinions for the standardized management of patients exhibiting resistance to third-generation EGFR-TKIs in clinical practice.

Keywords: EGFR mutation; Non-small cell lung cancer; Post-resistance management; Third-generation EGFR-TKI.

Publication types

  • Review