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Ultra-Fast Amplicon-Based Next-Generation Sequencing in Non-Squamous Non-Small Cell Lung Cancer
07:59

Ultra-Fast Amplicon-Based Next-Generation Sequencing in Non-Squamous Non-Small Cell Lung Cancer

Published on: September 8, 2023

Treatment patterns and outcomes of second/third-line therapy in advanced non-small cell lung cancer with actionable

Hanxiao Chen1, Xiangjiao Meng2, Ling Cai3

  • 1Department of Thoracic Oncology, Peking University Cancer Hospital and Institute, Beijing, China.

Clinical & Experimental Metastasis
|July 30, 2026
PubMed

Insights

Treatment patterns for advanced non-small-cell lung cancer (NSCLC) after initial targeted therapy show a shift towards chemotherapy combinations in later lines. Despite limited options, targeted therapies remain crucial, highlighting the need for novel treatments post-resistance.

Area of Science:

  • Oncology
  • Genomics
  • Clinical Research

Background:

  • Treatment selection for metastatic non-small-cell lung cancer (NSCLC) after first-line targeted therapy is inconsistent.
  • Characterizing real-world treatment patterns and outcomes is essential for advanced NSCLC with actionable genomic alterations (AGAs).

Purpose of the Study:

  • To analyze real-world treatment patterns and outcomes in second- (2L) and third-line (3L) settings for advanced NSCLC patients with AGAs.
  • To evaluate the utilization of different therapy categories including targeted monotherapy (T), targeted combinations (T+), chemotherapy monotherapy (C), chemotherapy combinations (C+), and anti-angiogenic monotherapy (A).

Main Methods:

  • Retrospective cohort study across six Chinese centers.
  • Inclusion of stage IV NSCLC patients with confirmed AGAs.
  • Categorization of therapies into T, T+, C, C+, A, and other regimens.
  • Analysis of treatment patterns, biomarker testing, and effectiveness (progression-free survival).

Main Results:

  • The cohort (n=658) was predominantly EGFR-mutant NSCLC (89.7%).
  • In 2L (n=602), targeted therapy use decreased from 75.3% in 1L to 49.3%, with increased anti-angiogenic plus chemotherapy (A+C) use (16.5%).
  • For T790M-negative patients progressing on first- or second-generation TKIs, over 51% continued targeted therapy in 2L.
  • In 3L (n=56), A+C (35.7%) and C (14.3%) were predominant.
  • Median real-world progression-free survival was 7.4 months in 2L and 5.4 months in 3L.

Conclusions:

  • Targeted therapies remain central to later-line advanced NSCLC management, particularly for EGFR-mutant disease.
  • The continued reliance on TKI therapy, even in T790M-negative patients, underscores limited post-resistance options.
  • There is a critical need to integrate novel therapeutics to address treatment challenges in advanced NSCLC post-progression.
Keywords:
Epidermal growth factor receptor mutationNon-small-cell lung cancerReal-world studySecond-line therapyTargeted therapy

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