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.