第三代表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKI）对于经典EGFR突变和EGFR T790M突变的非小细胞肺癌（NSCLC）具有良好的选择性。然而，第三代EGFR-TKI的抗药性不可避免地发生。本研究描述了使用160毫克氟莫替尼治疗进展期NSCLC的实际特征、疗效和安全性（与或不与抗血管生成剂和化疗联合）作为第三代EGFR-TKI的后续治疗方案。对进展至第三代EGFR-TKI的肺腺癌（NSCLC）患者的颅内进展模式队列（IP队列）或颅外进展模式队列（EP队列）进行了回顾性分析，这些患者接受160毫克氟莫替尼每日作为二线或后续治疗，与或不与抗血管生成剂和化疗联合使用。共纳入39例患者，并根据进展模式分成两组。然后，IP队列中有22例患者，EP队列中有17例患者，其中大多数患者身体状况较差，84.6%的患者出现中枢神经系统转移。在IP队列中，单药氟莫替尼或联合治疗的中位无进展生存期（PFS）为5.5个月（95% CI 4.67-8.72），中位总生存期（OS）为9.8个月（95% CI 7.25-11.20）。在EP队列中，中位PFS为3.2个月（95% CI 2.18-4.70），中位OS为6.7个月（95% CI 4.99-8.75）。单因素分析显示，先前存在T790M突变及放疗治疗史与氟莫替尼的PFS延长相关（p = 0.048，p = 0.004）。总体而言，84.6%的患者（33/39）发生了任何等级的不良事件（AEs），大多数患者的AEs达到2级或更低。对于发展出第三代EGFR-TKI治疗后产生抗药性的晚期NSCLC患者，特别是那些因颅内病变进展而发生抗药性的患者，160毫克氟莫替尼是一种可选疗法，具有良好的疗效和可接受的安全性，并值得进一步探索。版权所有© 2023 The Authors. Published by Elsevier B.V. All rights reserved.

Third-generation epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKI) show good selectivity for classical EGFR mutated and EGFR T790M mutated non-small cell lung cancer (NSCLC). However, resistance inevitably occurs to third-generation EGFR-TKI. This study describes the real-world characteristics, efficacy, and safety of treating post-progression NSCLC with 160 mg of furmonertinib (in combination with or without anti-angiogenic agents and chemotherapy) with third-generation EGFR-TKIs.EGFR-mutated NSCLC patients with intracranial progression pattern cohort (IP cohort) or extracranial progression pattern cohort (EP cohort) were retrospectively analyzed following progression to third-generation EGFR-TKIs receiving furmonertinib 160 mg daily as second-line or later treatment in combination with or without anti-angiogenic agents and chemotherapy.Thirty-nine patients were included and categorized into two groups according to the progression pattern. Then, 22 patients in the IP cohort and 17 patients in the EP cohort, most of whom were in poor physical condition, were included and 84.6% had central nervous system metastases. In the IP cohort, the median PFS was 5.5 months (95% CI 4.67-8.72), and the median OS was 9.8 months (95% CI 7.25-11.20) for single-agent furmonertinib or combination therapy. In the EP cohort, the median PFS was 3.2 months (95% CI 2.18-4.70), and the median OS was 6.7 months (95% CI 4.99-8.75). Univariate analysis showed the association between the presence of a prior T790M mutation and a history of combined radiotherapy with longer PFS with furmonertinib (p = 0.048, p = 0.004). Overall, adverse events (AEs) of any grade occurred in 84.6% of patients (33/39), with the majority having grade 2 or lower AEs.Furmonertinib 160 mg is an optional regimen for patients with advanced NSCLC who develop resistance after treatment with third-generation EGFR-TKIs, especially those developing resistance due to the progression of intracranial lesions, with good efficacy and an acceptable safety profile that warrants further exploration.Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.