Real-world outcomes of neoadjuvant targeted therapy in resectable epidermal growth factor receptor mutation-positive non-small cell lung cancer: a retrospective study
Year: 2026
Type: article
Abstract: Background: Multiple clinical trials have validated the efficacy of neoadjuvant targeted therapy (NTT) for resectable non-small cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutations. This retrospective study aimed to assess the efficacy and safety of neoadjuvant EGFR-tyrosine kinase inhibitors (EGFR-TKIs) in real-world cohorts, and to compare therapeutic outcomes across different generations of EGFR-TKIs in patients with EGFR-mutant resectable NSCLC. Methods: Patients diagnosed with EGFR-mutant lung adenocarcinoma who received NTT between July 2018 and April 2023 were retrospectively enrolled. All participants completed at least two cycles of neoadjuvant EGFR-TKI therapy before surgical resection. Results: Forty-five patients with EGFR-mutant lung adenocarcinoma were enrolled in the study, including 18 treated with first/second-generation EGFR-TKIs and 27 treated with third-generation EGFR-TKIs. The overall objective response rate (ORR) was 57.7%, and the major pathological response (MPR) rate was 26.7%. No significant intergroup difference was observed in MPR rates. Rash, dry skin, diarrhea and oral ulcerations were the most frequent adverse events (AEs), and no statistically significant intergroup disparity was detected in AE incidence. No patient experienced grade ≥3 severe AEs. Subgroup analysis showed no significant differences in 1-year and 3-year relapse-free survival (RFS) and overall survival (OS) between patients receiving first/second-generation EGFR-TKIs and those receiving third-generation EGFR-TKIs. Similarly, 1- and 3-year RFS and OS showed no statistical differences when stratified by early-stage versus locally advanced disease. Conclusions: In real-world clinical practice, EGFR-TKIs used as NTT for patients with resectable EGFR-mutant NSCLC show encouraging therapeutic potential and are associated with an absence of severe adverse reactions. Patients receiving distinct generations of EGFR-TKIs as neoadjuvant treatment demonstrated comparable long-term prognostic outcomes.
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7223395115