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Background  The study was conducted to assess differences in overall survival (OS) in patients with non‐small cell lung cancer (NSCLC) receiving different treatment modalities of tyrosine kinase inhibitors (TKIs).    Methods  A total of 463 NSCLC patients receiving TKI treatment were included. OS was compared according to treatment timing in all patients, the elderly, and patients positive for  EGFR  mutations.    Results  One hundred and seventy two patients received TKIs as first‐line treatment, 220 as second‐line, and 67 as third‐line. The results between the three groups were not statistically significant: the one, two, and three‐year OS rates were: 55.3%, 22.3%, and 11.3% (first‐line); 59.6%, 27.8%, and 14.9% (second‐line); and 53.8%, 41.3%, and 29.5% (third‐line), respectively ( P  = 0.095). Results between the three groups of elderly patients were also not statistically significant ( P  = 0.469). The one and two‐year OS rates in  EGFR  mutation‐positive patients receiving first‐line treatment were 48% and 17.5%, respectively. The one, two, and three‐year OS rates of patients receiving second‐line treatment were: 54.2%, 30.3%, and 20.2%, respectively. There were no statistically significant differences between the groups with EGFR mutations receiving first‐line or second‐line treatment. Thirteen  EGFR  mutation‐positive patients received third‐line TKI treatment for a median duration of 7 months. Their one and two‐year OS rates were 69.8% and 58.2%, respectively, which were higher than in the other two groups ( P  = 0.015).    Conclusion  Three lines of TKI therapy can prolong survival in NSCLC patients. Elderly patients can benefit from TKI therapy.  EGFR  mutation‐positive patients can benefit from second‐line or third‐line TKI therapy.

thoracic cancer

Survival analysis of patients with advanced non‐small cell lung cancer receiving tyrosine kinase inhibitor (TKI) treatment: A multi‐center retrospective study