{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T16:12:47Z","timestamp":1776183167029,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,11,24]],"date-time":"2022-11-24T00:00:00Z","timestamp":1669248000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005795","name":"Chang Gung Memorial Hospital, Linkou","doi-asserted-by":"publisher","award":["CIRPG3H0061~2"],"award-info":[{"award-number":["CIRPG3H0061~2"]}],"id":[{"id":"10.13039\/501100005795","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005795","name":"Chang Gung Memorial Hospital, Linkou","doi-asserted-by":"publisher","award":["CORPG3J0151~2"],"award-info":[{"award-number":["CORPG3J0151~2"]}],"id":[{"id":"10.13039\/501100005795","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005795","name":"Chang Gung Memorial Hospital, Linkou","doi-asserted-by":"publisher","award":["CMRPG3J0971~3"],"award-info":[{"award-number":["CMRPG3J0971~3"]}],"id":[{"id":"10.13039\/501100005795","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005795","name":"Chang Gung Memorial Hospital, Linkou","doi-asserted-by":"publisher","award":["CRRPG3K0021~2"],"award-info":[{"award-number":["CRRPG3K0021~2"]}],"id":[{"id":"10.13039\/501100005795","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005795","name":"Chang Gung Memorial Hospital, Linkou","doi-asserted-by":"publisher","award":["NMRPG3K6201~3"],"award-info":[{"award-number":["NMRPG3K6201~3"]}],"id":[{"id":"10.13039\/501100005795","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005795","name":"Chang Gung Memorial Hospital, Linkou","doi-asserted-by":"publisher","award":["CMRPG"],"award-info":[{"award-number":["CMRPG"]}],"id":[{"id":"10.13039\/501100005795","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Thoracic Cancer"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR\u2010TKIs) are the standard treatment for patients with non\u2010small cell lung cancer (NSCLC) harboring <jats:italic>EGFR<\/jats:italic> mutations. This study aimed to evaluate the efficacy of EGFR\u2010TKIs and prognostic factors for patients with NSCLC harboring uncommon <jats:italic>EGFR<\/jats:italic> mutations, which account for 10% of <jats:italic>EGFR<\/jats:italic> mutations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 230 treatment\u2010naive patients with NSCLC harboring uncommon <jats:italic>EGFR<\/jats:italic> mutations treated with first\u2010line EGFR\u2010TKIs between 2011 and 2018 at four hospitals (belonging to four institutions, Linkou, Kaohsiung, Keelung, and Chiayi, of the Chang Gung Memorial Hospital) in Taiwan were retrospectively reviewed. Their clinicopathological characteristics, adverse events (AEs), objective response rate (ORR), disease control rate (DCR), progression\u2010free survival (PFS), and overall survival (OS) were collected. Univariate and multivariate analyses were performed to identify potential prognostic factors for PFS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, patients who received afatinib (<jats:italic>n<\/jats:italic>\u00a0=\u00a062) had better PFS (median: 6.4 vs. 5.9\u2009months, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.022) and OS (median: 13.4 vs. 13.0\u2009months, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.008) than those who received gefitinib\/erlotinib (<jats:italic>n<\/jats:italic>\u00a0=\u00a0124), although no significant differences were observed for ORR (46.8% vs. 35.5%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.137) or DCR (59.7% vs. 58.9%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.916). Patients who received afatinib showed significantly higher ORR (58.3% vs. 31.3%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.027) but not DCR compared with gefitinib\/erlotinib for major uncommon mutations. Afatinib trended toward better PFS and OS for major uncommon mutations and compound mutations. No EGFR\u2010TKIs were effective for most NSCLC patients with exon 20 insertions. Performance status, metastasis of the liver and pleura, and dose reduction were independent prognostic factors for PFS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Afatinib demonstrated better survival outcomes than gefitinib\/erlotinib for NSCLC patients harboring major <jats:italic>EGFR<\/jats:italic> uncommon mutations and compound mutations. Performance status and metastatic sites may be useful for predicting PFS for major uncommon mutations and compound mutations.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1759-7714.14537","type":"journal-article","created":{"date-parts":[[2022,11,25]],"date-time":"2022-11-25T07:02:40Z","timestamp":1669359760000},"page":"12-23","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Epidermal growth factor receptor tyrosine kinase inhibitors for non\u2010small cell lung cancer harboring uncommon <scp><i>EGFR<\/i><\/scp> mutations: Real\u2010world data from Taiwan"],"prefix":"10.1111","volume":"14","author":[{"given":"John Wen\u2010Cheng","family":"Chang","sequence":"first","affiliation":[{"name":"Division of Hematology\u2010Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou Chang Gung University College of Medicine  Taoyuan 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