[Application of Immune Checkpoint Inhibitors in EGFR Mutant 
Advanced Non-small Cell Lung Cancer]

Area of Science:

• Oncology
• Immunotherapy
• Genetics

Background:

• Immune checkpoint inhibitors (ICIs) have improved survival in non-small cell lung cancer (NSCLC) without driver mutations.
• NSCLC tumors with epidermal growth factor receptor (EGFR) mutations exhibit heterogeneous immune microenvironments (e.g., PD-L1, TMB).
• The efficacy of ICIs in EGFR-mutated NSCLC remains controversial, with monotherapy showing limited benefit.

Purpose of the Study:

• To review clinical research on ICIs in advanced NSCLC patients with EGFR mutations.
• To explore the mechanisms underlying ICI efficacy in this patient subgroup.
• To evaluate both single-agent and combination ICI therapies.

Main Methods:

• Literature review of clinical studies and mechanistic research.
• Analysis of data regarding ICI monotherapy versus combination therapy.
• Focus on advanced NSCLC patients with documented EGFR mutations.

Main Results:

• ICI monotherapy has demonstrated no significant effect in EGFR-mutant NSCLC.
• Combination therapies (ICIs with chemotherapy and antiangiogenic drugs) show promising survival benefits.
• Heterogeneity in immune markers like PD-L1 and TMB exists in EGFR-mutant tumors.

Conclusions:

• ICI monotherapy is not recommended for EGFR-mutant NSCLC.
• Combination strategies involving ICIs are effective and improve survival in this population.
• Further research into mechanisms is needed to optimize treatment for EGFR-mutant NSCLC.