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EGFR-directed therapy

Source: Non-Small Cell Lung Cancer Treatment (PDQ®)–Health Professional Version, National Cancer Institute.

Source updated: May 15, 2025 · Captured 2026-09-09.

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Context: Treatment of Progressive Stage IV, Relapsed, and Recurrent NSCLC / Treatment Options for Progressive Stage IV, Relapsed, and Recurrent NSCLC (Second-Line Therapy)

Advanced NSCLC that contains characteristic EGFR variants (most commonly EGFR exon 19 deletions or EGFR L858R variants) is highly sensitive to EGFR TKIs. The standard approach to decide whether to use an EGFR TKI for the treatment of a patient with advanced NSCLC is to analyze the tumor for the presence or absence of an EGFR driver variant. EGFR exon 20 insertions are uncommon variants that are not sensitive to the EGFR TKIs used for the treatment of NSCLC with EGFR-sensitizing variants.

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EGFR-directed therapy after first-line chemotherapy (for patients with EGFR-sensitizing variants) →EGFR-directed therapy (for patients with acquired EGFR T790M variants after previous EGFR-directed therapy) →EGFR-directed therapy after first-line chemotherapy (for patients with EGFR exon 20 insertions) →

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