Chen Xue, Sun Yijia, Zhang Lihong, Jiang Bo
Kunming Medical University, Kunming 650500, China.
Department of Geriatric Oncology, the Third Affiliated Hospital of Kunming Medical University, Kunming 650118, China.
Zhongguo Fei Ai Za Zhi. 2025 May 20;28(5):334-342. doi: 10.3779/j.issn.1009-3419.2025.101.09.
For patients with advanced non-small cell lung cancer (NSCLC) harboring sensitive epidermal growth factor receptor (EGFR) mutations, guidelines prioritize the use of third-generation EGFR-tyrosine kinase inhibitors (EGFR-TKIs), which offer higher objective response rate (ORR), longer progression-free survival (PFS), and better quality of life. However, due to the low proportion of elderly patients enrolled in clinical trials, the existing evidence is insufficient to fully guide clinical practice. This review examines the efficacy and safety differences of third-generation EGFR-TKIs as monotherapy or in combination in the elderly NSCLC by integrating subgroup analyses or pre-specified research objectives from prospective and retrospective studies. The results show that third-generation EGFR-TKIs have comparable efficacy in elderly patients to younger populations and are well-tolerated. Although combination therapies may extend survival time, the associated increased toxicity necessitates careful risk-benefit assessment. .
对于携带敏感表皮生长因子受体（EGFR）突变的晚期非小细胞肺癌（NSCLC）患者，指南优先推荐使用第三代EGFR酪氨酸激酶抑制剂（EGFR-TKIs），这类药物具有更高的客观缓解率（ORR）、更长的无进展生存期（PFS）以及更好的生活质量。然而，由于参与临床试验的老年患者比例较低，现有证据不足以充分指导临床实践。本综述通过整合前瞻性和回顾性研究的亚组分析或预先设定的研究目标，考察了第三代EGFR-TKIs单药治疗或联合治疗老年NSCLC患者时的疗效和安全性差异。结果表明，第三代EGFR-TKIs在老年患者中的疗效与年轻人群相当，且耐受性良好。虽然联合治疗可能会延长生存时间，但相关毒性增加需要仔细评估风险效益。
