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Background  Epidermal growth factor receptor‐tyrosine kinase inhibitors ( EGFR‐TKIs ) effectively treat advanced non‐small cell lung cancer with  EGFR ‐mutation. However, most patients develop acquired resistance without effective therapy subsequent to  EGFR‐TKI  failure. We evaluated the efficacy of subsequent treatment strategies for  EGFR‐TKI  resistance.    Methods  We retrospectively analyzed 240 patients with advanced lung adenocarcinoma with  EGFR‐TKI  failure and following subsequent treatment. According to the first subsequent strategies after  EGFR ‐ TKI  failure, patients were divided into groups of  EGFR‐TKI  continuation (21 cases),  EGFR‐TKI  continuation with chemotherapy (23 cases), chemotherapy alone (143 cases), and best supportive care ( BSC ) (53 cases).    Results  Except for 53 cases of  BSC , the disease control rates ( DCR ) of the remaining 187 patients in the  EGFR‐TKI  continuation,  EGFR‐TKI  continuation with chemotherapy, and chemotherapy alone groups were 66.7%, 73.9%, and 44.8%, respectively. The median post‐progression progression‐free survival ( PFS ) for the three groups was 3.0, 3.3, and 2.0 months, respectively. The  DCR  for the  EGFR‐TKI  continuation with chemotherapy group was significantly higher than the chemotherapy alone group ( P  = 0.006). The post‐progression  PFS  of the  EGFR‐TKI  continuation with chemotherapy group was significantly longer than the chemotherapy alone group ( P  = 0.037). The median overall survival in the  EGFR‐TKI  continuation,  EGFR‐TKI  continuation with chemotherapy, chemotherapy alone, and  BSC  groups were 6.9, 11.6, 8.8, and 0.9 months, respectively. Compared to the  BSC  group, all groups achieved a survival benefit ( P  < 0.001).    Conclusions   EGFR‐TKI  continuation with chemotherapy could provide benefits for patients with acquired resistance to  EGFR‐TKI .

Subsequent treatment of epidermal growth factor receptor‐tyrosine kinase inhibitor failure in patients with advanced lung adenocarcinoma