Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) are the standard first-line option for non-small-cell lung cancer (NSCLC) harboring active EGFR mutations. The overall survival of patients with advanced NSCLC has improved dramatically with the development of comprehensive genetic profiles and targeted therapies. However, resistance inevitably occurs, leading to disease progression after approximately 10-18 months of EGFR-TKI treatment. Platinum-based chemotherapy is the standard treatment for patients who have experienced disease progression while undergoing EGFR-TKI treatment, but its efficacy is limited. The management of extensively pretreated patients with EGFR-mutant NSCLC is becoming increasingly concerning. New agents have shown encouraging efficacy in clinical trials for this patient population, including fourth-generation EGFR-TKIs, EGFR-TKIs combined with counterpart targeted drugs, and novel agents such as antibody-drug conjugates. We review current efforts to manage extensively pretreated patients with EGFR-mutant NSCLC.

中文翻译：

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用于治疗经酪氨酸激酶抑制剂预处理的表皮生长因子受体突变非小细胞肺癌患者的新型全身疗法。

表皮生长因子受体酪氨酸激酶抑制剂 (EGFR-TKI) 是具有活性 EGFR 突变的非小细胞肺癌 (NSCLC) 的标准一线选择。随着全面基因谱和靶向治疗的发展，晚期非小细胞肺癌患者的总体生存率显着提高。然而，耐药性不可避免地发生，导致 EGFR-TKI 治疗约 10-18 个月后疾病进展。铂类化疗是接受 EGFR-TKI 治疗期间出现疾病进展的患者的标准治疗方法，但其疗效有限。对 EGFR 突变 NSCLC 患者进行广泛预处理的管理变得越来越令人担忧。新药在针对该患者群体的临床试验中显示出令人鼓舞的疗效，包括第四代 EGFR-TKI、EGFR-TKI 联合对应靶向药物以及抗体药物偶联物等新药。我们回顾了目前对 EGFR 突变 NSCLC 患者进行广泛预处理的管理工作。