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Furmonertinib rechallenge for first-line third-generation EGFR TKI-resistant EGFR-mutant NSCLC: A retrospective
Jiaqi Zhao1, Maolin Liu1, Siqing Liu1
1Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
Background:
Overcoming resistance of first-line third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) for non-small cell lung cancer (NSCLC) remained a challenge. This study aimed to compare the effectiveness of furmonertinib rechallenge and chemotherapy in this setting.
Methods:
NSCLC patients receiving furmonertinib or chemotherapy after progression on first-line third-generation EGFR TKIs were included. Characteristics were used for propensity score matching through a multivariable logistic regression model. Objective response rates (ORR) and disease control rates (DCR) were compared using chi-squared test between the two groups in unmatched patients and McNemar test in matched patients. Kaplan-Meier curves of progression-free survival (PFS) and overall survival (OS) were plotted. Hazard ratios (HR) for PFS were calculated using Cox proportional hazards models.
Results:
Totally 97 patients were included (31 in the furmonertinib group and 66 in the chemotherapy group), and 28 pairs were matched. Most characteristics were well-balanced. In unmatched patients, ORR and DCR were similar in the two groups (both P > 0.05). Median PFS were 8.6 and 8.5 months (HR 1.02 [95% CI 0.60-1.74]; P = 0.948). Median OS were not reached and 32.0 months. In matched patients, ORR and DCR were also comparable (both P > 0.05). Median PFS for furmonertinib was numerically longer than that for chemotherapy (8.6 months vs 5.7 months; HR 0.67 [95% CI 0.35-1.28]; P = 0.223). Median OS were not reached. Furmonertinib also had superior safety profiles compared with chemotherapy.
Conclusions:
Furmonertinib showed similar effectiveness and better safety compared with chemotherapy in NSCLC patients resistant to first-line third-generation EGFR TKIs. After matching, furmonertinib demonstrated numerically longer PFS than chemotherapy. Randomized controlled trials are warranted.
Insights
Furmonertinib rechallenge offers comparable effectiveness and improved safety over chemotherapy for non-small cell lung cancer (NSCLC) patients resistant to first-line EGFR TKIs. This suggests furmonertinib as a viable alternative treatment option.
Area of Science:
- Oncology
- Medical Research
Background:
- Resistance to first-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) is a significant challenge in non-small cell lung cancer (NSCLC) treatment.
- Evaluating alternative therapies like furmonertinib rechallenge is crucial for improving patient outcomes.
Purpose of the Study:
- To compare the effectiveness and safety of furmonertinib rechallenge versus chemotherapy in NSCLC patients who progressed on first-line third-generation EGFR TKIs.
Main Methods:
- A retrospective study included 97 NSCLC patients, with 28 pairs matched using propensity scores.
- Effectiveness was assessed by objective response rates (ORR), disease control rates (DCR), progression-free survival (PFS), and overall survival (OS).
- Safety profiles were also compared between the furmonertinib and chemotherapy groups.
Main Results:
- In unmatched patients, furmonertinib and chemotherapy showed similar ORR and DCR.
- In matched patients, furmonertinib demonstrated a numerically longer median PFS (8.6 months vs. 5.7 months) compared to chemotherapy.
- Furmonertinib exhibited a superior safety profile with fewer adverse events than chemotherapy.
Conclusions:
- Furmonertinib rechallenge is a viable treatment option for NSCLC patients resistant to first-line third-generation EGFR TKIs, offering similar effectiveness and better safety than chemotherapy.
- Further investigation through randomized controlled trials is recommended to confirm these findings.
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