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Objective <p>To evaluate the efficacy and safety of third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) in combination with radiotherapy (RT) for patients with advanced non-small cell lung cancer (NSCLC) harboring typical EGFR mutations.</p> Methods <p>Patients who received treatment with third-generation EGFR-TKIs alone&#xa0;or in combination with RT were retrospectively enrolled at a single center. The primary endpoint was progression-free survival (PFS). Differences in PFS between the two groups were assessed via the Kaplan–Meier method. Additionally, a subgroup analysis was conducted to further explore the effect of thoracic RT combined with EGFR-TKIs.</p> Results <p>This study included a total of 260 patients, among whom 81 patients received third-generation EGFR-TKIs and 179 patients received third-generation EGFR-TKIs plus RT. There was a significant difference in median PFS (mPFS) (13.0 <i>versus</i> 18.1&#xa0;months, <i>P</i> = 0.0003) between the two groups. Moreover, third-generation EGFR-TKIs plus thoracic RT significantly improved the mPFS (13.0 <i>versus</i> 23.7&#xa0;months, <i>P</i> &lt; 0.0001). We observed that third-generation EGFR-TKIs plus RT increased the incidence of pneumonia, but all the cases were grade 1 or 2.</p> Conclusion <p>The addition of RT can delay the occurrence of acquired resistance to third-generation EGFR-TKIs, thereby significantly prolonging PFS in advanced NSCLC patients. RT for primary lung lesions exhibited a significant synergistic effect with EGFR-TKI treatment, and the adverse events of the combination therapy were acceptable.</p>

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Efficacy and Safety of Third-Generation EGFR-TKIs Combined with Radiotherapy for Advanced NSCLC with Typical EGFR Mutations: A Retrospective Study

  • 期刊论文

  • 发表日期：

    2025年3月11日

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  • Wen-xuan Zhang,
  • Hui-chan Xue,
  • Ye Zhao,
  • Shuang-bing Xu

摘要

Objective

To evaluate the efficacy and safety of third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) in combination with radiotherapy (RT) for patients with advanced non-small cell lung cancer (NSCLC) harboring typical EGFR mutations.

Methods

Patients who received treatment with third-generation EGFR-TKIs alone or in combination with RT were retrospectively enrolled at a single center. The primary endpoint was progression-free survival (PFS). Differences in PFS between the two groups were assessed via the Kaplan–Meier method. Additionally, a subgroup analysis was conducted to further explore the effect of thoracic RT combined with EGFR-TKIs.

Results

This study included a total of 260 patients, among whom 81 patients received third-generation EGFR-TKIs and 179 patients received third-generation EGFR-TKIs plus RT. There was a significant difference in median PFS (mPFS) (13.0 versus 18.1 months, P = 0.0003) between the two groups. Moreover, third-generation EGFR-TKIs plus thoracic RT significantly improved the mPFS (13.0 versus 23.7 months, P < 0.0001). We observed that third-generation EGFR-TKIs plus RT increased the incidence of pneumonia, but all the cases were grade 1 or 2.

Conclusion

The addition of RT can delay the occurrence of acquired resistance to third-generation EGFR-TKIs, thereby significantly prolonging PFS in advanced NSCLC patients. RT for primary lung lesions exhibited a significant synergistic effect with EGFR-TKI treatment, and the adverse events of the combination therapy were acceptable.