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. 2023 Aug 24;12(8):1661–1701. doi: 10.21037/tlcr-23-339

Table 3. Follow up treatment for patients with diffuse metastases after targeted therapy.

Driver gene types Setting Recommending
EGFR19del/L858R EGFR T790M mutation after first- or second-generation EGFR-TKIs Osimertinib, almonertinib, furmonertinib
EGFR T790M mutation-negative after first- or second-generation EGFR-TKIs Chemotherapy, anti-VEGF treatment
Third-generation EGFR-TKIs Chemotherapy, anti-VEGF treatment
ALK fusion First-line treatment with first-generation ALK-TKIs Alectinib, ceritinib, brigatinib, ensartinib
First-line treatment with second-generation ALK-TKIs Lorlatinib
ROS1 fusion Crizotinib, ceritinib, entrectinib Lorlatinib

ALK, anaplastic lymphoma kinase; EGFR, epidermal growth factor receptor; ROS1, ROS proto-oncogene 1, receptor tyrosine kinase; TKIs, tyrosine kinase inhibitors; VEGF, vascular endothelial growth factor; 19del, 19 exon deletion.