Kenzo Soejima

Abstract The EXTRA trial was the first to identify predictive biomarkers for afatinib efficacy in epidermal growth factor receptor (EGFR)-mutant NSCLC. We analyzed the clinical data of older adult patients before translational analysis. This prospective study involved untreated patients with EGFR-mutant NSCLC who received afatinib at an initial dose of 40 mg/day, followed by stepwise dose reductions, ultimately reaching 20 mg administered every other day.

Abstract Although EGFR tyrosine kinase inhibitors (EGFR-TKIs) are effective for EGFR-mutant lung adenocarcinoma (LUAD), resistance inevitably develops through diverse mechanisms, including secondary genetic mutations, amplifications and as-yet undefined processes.

Highlights • EGFR-mutated non-ADC patients are more prone to distant metastasis. • EGFR-mutated non-ADC patients are more prone to malignant pleural effusion. • ADC and EGFR del19-positive non-ADC patients can benefit from EGFR-TKI treatment. • EGFR L858R-positive non-ADC patients might not benefit from the EGFR-TKI treatment. • EGFR L858R-positive non-ADC patients may require different therapeutic options.