CONTRADICTING EVIDENCE: A retrospective study was carried out. Three hundred and twenty-four patients with advanced non-small cell lung cancer with EGFR common mutations (del exon 19 and L858R) treated with upfront EGFR TKI...Patients with L858R mutation had a significantly lower median intracranial PFS of 38 months ( CI95%: 26.7- NR) in comparison with a median icPFS of 69.7 months ( CI95%: 57.8 - NR) with patients with exon 19 deletion (HR 2.27, CI95% 1.46-3.53 p=<0.001)....L8585 is associated with a higher rate of brain metastases development and a lower intracranial PFS.

We conducted a multi-institutional retrospective analysis of pts with stage III unresectable EGFRmut NSCLC (exon19 deletion, exon21 L858R), who received EGFR TKI or durva after ≥ 2 cycles of platinum-based chemotherapy plus definitive radiation therapy between 2015-2022....EGFR TKI therapy after definitive CRT was associated with significantly longer DFS compared to durva in this retrospective study of pts with stage III unresectable EGFRmut NSCLC, without unanticipated safety signals.

Eligible patients were histologically confirmed to have NSCLC with an EGFR-sensitive mutation (19DEL or 21L858R) and diagnosed at stage IV….The median PFS of the EGFR-TKI group and SBRT combination group was 9.0 vs 17.6 months (hazard ratio [HR] = 0.52, 95% confidence interval [95%CI], 0.31-0.89, P = 0.016). Meanwhile, the median OS was 23.2 vs 33.6 months (HR [95%CI], 0.53(0.30-0.95); P = 0.026)....The addition of SBRT significantly delayed the onset of acquired resistance to EGFR-TKIs and prolonged the PFS and OS of patients.

CONTRADICTING EVIDENCE: This study was conducted in patients who were diagnosed with NSCLC from January 2015 to December 2019....Among the patients with contra-lateral lung metastasis harboring EGFR mutation, there were 182 patients enrolled in the outcome statistical analysis with EGFR-TKI prescription as initial systemic therapy....Multivariate analysis by Cox proportional hazard model identified poor performance status (in TD-TKI, PFS and OS) (Tables 2, 3, 4), liver metastasis (in TD-TKI, PFS and OS) (Tables 2, 3, 4), and L858R mutation (in OS) (Table 4) as independent and strong prognostic indicators for poor survival.

...for NSCLC patients with EGFR-sensitive mutations (Exon19 Del, L858R), patients treated with co-administration of EGFR-TKIs with SFI achieve more prolonged clinical benefit and longer PFS than treated with the first-generation of EGFR-TKIs alone, and SFI clinically effectively retards the occurrence of first-generation EGFR-TKIs resistance.

We performed a single-institution retrospective analysis of patients with EGFR-mutant NSCLC (exon 19 deletion or L858R mutation) who received frontline EGFR TKI...Of 137 patients, 72 (57%) had EGFR exon 19 deletions and 65 (43%) had EGFR L858R mutations. Median TTF and OS on frontline TKI was shorter for the L858R cohort versus the exon 19 deletion cohort in univariate analysis.

Advanced NSCLC patients harboring uncommon (other than L858R and exon 19 deletion) EGFR mutations at baseline tissue biopsy were selected...three patients harboring concurrent de-novo resistant T790M and a common sensitive EGFR mutation (L858R or exon 19del) achieved partial response using first and second-generation EGFR-TKIs.

A total of 429 patients met selection criteria were included in the study, among whom 209（48.7%）patients had exon 19 deletion, 165（38.5%）had L858R exon...In multivariable analysis, use of EGFR-TKIs (yes v not: HR = 0.56, 95%CI 0.43-0.74, P<0.001) and stage (IIIA v IIIB: HR = 0.67, 95% CI 0.51-0.87, P=0.003) were independently associated with PFS; and age was independently associated with OS...By multivariable analysis, EGFR-TKIs independently increased the DMFS (yes v not: HR 0.51,95%CI 0.37-0.70, P<0.001)....

...group1 patients harboring EGFR uncommon mutation in combination with EGFR 19 del/L858R; group 2 patients harboring single or complex EGFR uncommon mutations. Our analyses revealed that the median PFS (mPFS) of group 1 was significantly longer than those in groups 2 (14.65 months vs 8.05 months; P = 0.004)....analysis revealed that patients receiving 2nd generation TKI (p = 0.006, HR:0.277,95%CI:0.112-0.688) and coexist with 19del/L858R (p < 0.001, HR: 0.148,95% CI:0.065-0.333) were independently associated with favorable PFS; while concurrent TP53 mutation was independently associated with worse PFS (p = 0.008, HR: 2.530,95% CI:1.270-5.042)....EGFR mutations in combination with 19del/L858R were associated with favorable PFS. The presence of concurrent tumor-suppressor genes mutations especially TP53 is associated with worse prognosis. Patients treated with 2nd generation EGFR-TKI showed a longer PFS...

Among the 730 NSCLC patients with BM, 133 were found to have EGFR mutations, including 24.3% (33) with exon 19 deletions and 24.3% (33) with exon 21-point mutation (L858R). One patient had both exon 19 and exon 21-point mutations...Of the 133 BM cases...65 had received EGFR-TKI...treatment by TKI (HR= 1.805; 95% CI: 1.277–2.552; factors = 0.001), and NLR (HR = 1.805; 95% CI: 1.277–2.552; factors =0.001) were associated with longer OS... The results showed that pretreatment and treatment factors including age below 65, nonsmoker, high KPS, lower number of brain lesions, absence of extracranial metastases, and being treated with WBRT or EGFR-TKI were associated with a longer overall survival...

Out of the 33 patients with rare EGFR variants, EGFR TKI therapy was administered in 3 patients with advanced NSCLC….The third patient had a concurrent L858R mutation, responded to TKI therapy and is alive one year post diagnosis.