Abstract

Lung cancer is one of the most common cancers in terms of morbidity and mortality. Among them, non-small cell lung cancer (NSCLC) accounts for 90% of lung cancer patients. Epidermal Growth Factor Receptor (EGFR) mutations are also the most common type of driver gene mutation in advanced NSCLC. In Chinese NSCLC patients, the proportion of EGFR mutations was 28.2%, and this proportion increased to 50.2% in lung adenocarcinoma. All three generations of Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors (EGFR-TKI) are effective therapeutics for lung cancer patients carrying EGFR-sensitive mutations or T790M mutations, each of which has its own advantages and characteristics, as well as its own limitations and adverse reactions. Befortinib, which is new to the market in 2023, has better Median progression-free survival (mPFS). However, three generations of EGFR-TKI cannot completely overcome the resistance mechanism of lung cancer. In addition to the T790M mutation, there are other mutations or mechanisms that cause lung cancer to become resistant to third-generation EGFR-TKI, such as C797S mutation, MET amplification, HER2 amplification, etc. At present, the fourth-generation of EGFR-TKI is still under continuous research and development.

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