Table 2

Clinical definition27 and subtyping28 of acquired resistance to EGFR-TKIs in lung cancer

Criteria of acquired resistance to EGFR-TKIs in lung cancer by Jackman et al27
  1. Previously received treatment with a single-agent EGFR-TKI (eg, gefitinib or erlotinib)

  2. Either of the following:

    1. A tumour that harbours an EGFR mutation known to be associated with drug sensitivity (ie, G719X, exon 19 deletion, L858R, L861Q)

    2. Objective clinical benefit from treatment with an EGFR-TKI as defined by either:

      1. Documented partial or complete response (RECIST or WHO)

      2. Significant and durable (≥6 months) clinical benefit (stable disease as defined by RECIST or WHO) after initiation of gefitinib or erlotinib

  3. Systemic progression of disease (RECIST or WHO) while on continuous treatment with gefitinib or erlotinib within the past 30 days

  4. No intervening systemic therapy between cessation of gefitinib or erlotinib and initiation of new therapy

Clinical subtyping of acquired resistance to EGFR-directed TKI therapy in patients with NSCLC according to PD by Gandara et al28
Type of PDManagement
(1) CNS sanctuary PDLocal therapy (eg, surgery, radiotherapy or both) with continuation of the present EGFR-TKI
(2) Oligo-PDLocal therapy (eg, surgery, radiotherapy or both) with continuation of the present EGFR-TKI
(3) Systemic PDIf slowly progressing lesions, or lesions smaller than pretreatment, or progression without worsening of systemic symptoms and/or signs, continuation of the present EGFR-TKI may be considered
  • CNS, central nervous system; EGFR, epidermal growth factor receptor; NSCLC, non-small cell lung cancer; PD, progression disease; RECIST, Response Evaluation Criteria in Solid Tumors; TKI, tyrosine kinase inhibitor.