Microwave ablation combined with third-generation epidermal growth factor receptor-tyrosine kinase inhibitor treatment in EGFR-mutant advanced non-small cell lung cancer.

Objectives: We aimed to verify the efficacy and safety of microwave ablation (MWA) in combination with third-generation epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) administration for EGFR-mutant advanced non-small cell lung cancer (NSCLC).

Materials and methods: Individuals with advanced NSCLC and EGFR mutations who underwent third-generation EGFR-TKI treatment and MWA (EGFR-TKI treatment followed by MWA [Group E + M] and MWA followed by EGFR-TKI treatment [Group M + E]) were retrospectively enrolled. The primary endpoint was duration of response (DoR).

Results: There were 12 patients in Group E + M and 16 in Group M + E. The overall median DoR was 21.9 months (95% confidence interval [CI]: 17.3-26.4). The median DoR was 25.7 months (95% CI: 20.6-30.9) and 20.5 months (95% CI: 5.9-35.1) in Group E + M and Group M + E (P = 0.996), respectively. When EGFR-TKIs were used as a first-line treatment, the median DoR overall and that of patients in Groups E + M and M + E were 29.3 months (95% CI: 19.2-39.4), 29.3 months (95% CI: 21.0-37.5), and not reached (P = 0.252), respectively. Major complications related to pneumothorax were observed in five patients, with no difference observed between the groups.

Conclusion: Patients with advanced EGFR-mutant NSCLC who underwent third-generation EGFR-TKI treatment plus MWA had a superior DoR and experienced minimal complications.