Consensus on the lung cancer management after third-generation EGFR-TKI resistance
Qing Zhou, Hongyun Zhao, Shun Lu, Ying Cheng, Ying Liu, Mingfang Zhao, Zhuang Yu, Chengping Hu, Li Zhang, Fan Yang, Jun Zhao, Renhua Guo, Rui Ma, Yingying Du, Xiaorong Dong, Jiuwei Cui, Daniel S.W. Tan, Myung-Ju Ahn, Masahiro Tsuboi, Si‐Yang Maggie Liu, Tony Mok, Yi‐Long Wu
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.