Conmana (icotinib)

The patient was managed with a combination therapy of icotinib (an EGFR-TKI) and Pirfenidone (an anti-fibrotic agent). Tumor molecular testing is also important in patients with NSCLC concurrent with IPF. Furthermore, it provides preliminary clinical evidence suggesting that, with careful monitoring and concomitant anti-fibrotic therapy, EGFR-TKIs like Icotinib may represent a viable treatment option for patients co-existing with IPF and EGFR-mutated NSCLC.

P1, N=94, Not yet recruiting, Fuzhou General Hospital

Since 1997, EGFR tyrosine kinase inhibitors (EGFR-TKIs) have evolved from first-generation agents, such as gefitinib, erlotinib, and icotinib, to second-generation agents like afatinib and dacomitinib, now to third-generation agents, including osimertinib, aumolertinib, furmonertinib, befotertinib, rezivertinib, rilertinib, limertinib, lazertinib, mifanertinib for EGFR L858R, sunvozertinib for EGFR exon 20 insertion (20ins), and zorifertinib for EGFR-sensitive mutation with brain metastases. Over the past 30 years, substantial advancements have been made in the comprehensive management of EGFR-mutant NSCLC. This systemic review provides the history of the development of EGFR-TKI therapy for NSCLC from 1997 to 2026, highlighting clinical milestones, emerging therapies, and future directions in this rapidly evolving field.

The combination of aumolertinib and icotinib shows encouraging efficacy and a tolerable safety profile in patients with EGFR-mutant NSCLC and BMs, supporting its potential as a therapeutic option warranting further investigation.

Adjuvant immunotherapies for lung cancer deliver meaningful clinical benefits, but their economic value and affordability are highly context-specific. While several strategies are cost-effective at the individual patient level, health system affordability is strongly influenced by the pace and scale of adoption. Scenario-based budget impact analyses demonstrate that accelerated uptake can impose substantial short-term fiscal pressure, whereas phased or restricted implementation markedly improves affordability without altering cost-effectiveness conclusions. These findings underscore the importance of integrating cost-effectiveness evidence with explicit consideration of budget impact, adoption strategies, and managed entry mechanisms to support sustainable and equitable scale-up of adjuvant immunotherapies in routine clinical practice.

The patient showed no meaningful response to EGFR-tyrosine kinase inhibitors (EGFR-TKIs), including the first-generation (Icotinib), the second-generation (Afatinib) and the third-generation (Aumolertinib). Trophoblast cell surface antigen 2-antibody-drug conjugate (TROP2-ADC) and immune checkpoint inhibitors (ICIs) combined with Bevacizumab also resulted in limited efficacy. Based on the clinical features and treatment response of this case, we reviewed the published literature about the pathological characteristics, mutational landscape, and current therapeutic approaches for PEAC, with a particular focus on the therapeutic challenges and future research directions for EGFR-mutant PEAC, aiming to provide insights for clinical practice and further studies..

P=N/A, N=88, Not yet recruiting, Beijing Hospital; Beijing Hospital

P=N/A, N=200, Not yet recruiting, Beijing Chest Hospital Capital Medical University; Beijing Chest Hospital Capital Medical University

P4, N=178, Not yet recruiting, Beijing chest hospital capital medical university; Beijing Chest Hospital Capital Medical University

A female patient in her late 40s with Stage IVB EGFR L858R lung adenocarcinoma exhibiting high BCL-2 expression was treated with radiotherapy and icotinib...Upon AML relapse, a fast in vivo MiniPDX drug sensitivity assay guided the selection of a salvage combination therapy (Selinexor, Decitabine, and Venetoclax)...This case highlights the complexity of managing these distinct malignancies, where the lung tumor's BCL-2 expression provided a rationale for the AML therapy. Furthermore, the MiniPDX assay proved valuable in guiding personalized therapy for refractory disease, demonstrating the potential of functional precision medicine strategies.

Metastatic burden remains a key prognostic factor. These findings support dose escalation as a viable strategy for frail populations with limited access to next-generation TKIs.

Two patients experienced disease recurrence and were successfully switched to osimertinib upon identification of an EGFR (T790M) mutation. This study suggests a potential DFS benefit and well-tolerated profile of adjuvant icotinib in patients with EGFR-mutated high-risk stage IB NSCLC. However, longer-term follow-up is necessary to assess the long-term outcomes.