Evidence map›Paper›PMID 42170254›Full record

ReviewTranslational lung cancer research2026

The resistance landscape of EGFR tyrosine kinase inhibitors in advanced non-small cell lung cancer: molecular mechanisms and novel therapeutic strategies.

Shuotong Liu, Linsen Zhou, Yongze He, Qianyi Liu, Ying Tang, Zhen Liu, Xianhu Zeng, Jiangping Li

Abstract readReview
In one paragraph

Review in Translational lung cancer research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Shuotong Liu *West China Clinical Medical College of Sichuan University, Chengdu, China.
Linsen Zhou *Department of Radiotherapy Physics & Technology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
Yongze HeWest China Clinical Medical College of Sichuan University, Chengdu, China.
Qianyi LiuWest China Clinical Medical College of Sichuan University, Chengdu, China.
Ying TangWest China Clinical Medical College of Sichuan University, Chengdu, China.
Zhen LiuDepartment of Radiotherapy Physics & Technology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
Xianhu ZengDepartment of Radiotherapy Physics & Technology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
Jiangping LiDivision of Thoracic Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Lung cancer remains the leading cause of global cancer-related mortality, with non-small cell lung cancer (NSCLC) constituting the predominant histological subtype. The discovery of epidermal growth factor receptor (EGFR) as a driver oncogene and elucidation of its mechanism of action through three canonical signaling pathways have driven the evolution of tyrosine kinase inhibitors (TKIs) from first to third generation. Following this breakthrough, EGFR-TKIs have revolutionized the treatment landscape for advanced EGFR-mutant NSCLC, significantly improving patient outcomes compared to conventional chemotherapy. However, the development of acquired resistance to EGFR-TKIs presents a major clinical challenge, ultimately limiting their long-term efficacy. Understanding this evolutionary trajectory and the architectural logic of the underlying signaling network lays the foundation for deciphering resistance mechanisms and designing next-generation therapeutic strategies. This comprehensive review systematically examines the molecular mechanisms underlying both intrinsic and acquired resistance to EGFR-TKIs, with a particular focus on third-generation agents like osimertinib. Key resistance mechanisms encompass on-target EGFR modifications (including tertiary C797S mutations and T790M loss), activation of bypass signaling pathways (such as MET, HER2, and AXL amplification), downstream pathway alterations (involving KRAS/BRAF and PI3K/AKT/mTOR cascades), and histologic transformations [including small cell lung cancer (SCLC) transformation and epithelial-mesenchymal transition (EMT)]. The review further explores current and emerging strategies to overcome these resistance mechanisms, including the development of fourth-generation TKIs, rational combination therapies targeting parallel pathways, and biomarker-guided treatment approaches. Understanding the complex landscape of EGFR-TKI resistance is paramount for developing novel therapeutic strategies and optimizing clinical outcomes for patients with advanced EGFR-mutant NSCLC.

Indexed as

drug resistanceEpidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI)non-small cell lung cancer (NSCLC)

Identifiers

PMID42170254
PMCPMC13186667

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.