对于驱动突变阳性晚期肺腺癌 (LUAD) 患者，目前尚无标准的三线或三线以上治疗方法。安罗替尼于2018年在中国被批准为三线多靶点药物。有关安罗替尼与化疗相比的疗效和安全性的数据有限。探讨安罗替尼与传统化疗相比对表皮生长因子受体（EGFR）阳性晚期 LUAD 患者的疗效和安全性。我们对 2011 年至 2022 年间 83 例 EGFR 突变阳性晚期 LUAD 患者进行了回顾性研究。无进展生存期 (PFS) 和总生存期 (OS) 是主要终点，而客观缓解率 (ORR) 和疾病控制率（DCR）是次要终点。记录与安罗替尼相关的不良事件（AE）以评估安罗替尼的安全性。 39 名 LUAD 患者接受了安罗替尼治疗，44 名 LUAD 患者接受了化疗。与接受化疗的患者相比，接受安罗替尼治疗的患者表现出更长的 PFS（11.2 个月 vs 4.5 个月，P<0.01）和 OS（18.8 个月 vs 15.8 个月，P<0.05）。两组之间的 ORR（7.9% vs 20.5%，P = .129）或 DCR（100% vs 93.2%，P = .120）无显着差异。在 2 名（5.1%）患者中观察到与安罗替尼相关的 3-4 级 AE，没有记录与安罗替尼相关的死亡。 PFS 和 OS 的 Cox 回归分析表明，脑转移和诊断时年龄≤30 岁对临床结果有负面影响。安罗替尼对于 EGFR 阳性晚期 LUAD 患者有效且安全。无脑转移的患者有更好的临床结果。

There are no standard third-line or beyond treatments for patients with driver mutation-positive advanced lung adenocarcinoma (LUAD). Anlotinib was approved as a third-line multitarget drug in China in 2018. Limited data are available regarding the efficacy and safety of anlotinib compared with chemotherapy. To investigate the efficacy and safety of anlotinib compared with traditional chemotherapy in patients with epidermal growth factor receptor (EGFR)-positive advanced LUAD. We conducted a retrospective study of 83 EGFR mutation-positive patients with advanced LUAD between 2011 and 2022. Progression-free survival (PFS) and overall survival (OS) were the primary endpoints, whereas the objective response rate (ORR) and disease control rate (DCR) were the secondary endpoints. Anlotinib-related adverse events (AEs) were recorded to evaluate the safety of anlotinib. 39 patients with LUAD received anlotinib and 44 patients with LUAD received chemotherapy were enrolled in the study. Patients treated with anlotinib exhibited longer PFS (11.2 vs 4.5 months, P < .01) and OS (18.8 vs 15.8 months, P < .05) than patients treated with chemotherapy. There were no significant differences in ORR (7.9% vs 20.5%, P = .129) or DCR (100% vs 93.2%, P = .120) between the two groups. Anlotinib-related AEs grading 3-4 level were observed in 2 (5.1%) patients, no anlotinib-related death was recorded. Cox regression analyses of PFS and OS showed that brain metastases and age < 30 years at diagnosis had negative effects on clinical outcomes. Anlotinib is effective and safe in patients with EGFR-positive advanced LUAD. Patients without brain metastases had better clinical outcomes.