Furmonertinib is a third-generation EGFR-TKI (epidermal growth factor receptor tyrosine kinase inhibitor) primarily used for the treatment of locally advanced or metastatic non-small cell lung cancer (NSCLC) carrying specific EGFR gene mutations. Its core indications include: ① first-line treatment for advanced NSCLC with EGFR sensitive mutations (such as exon 19 deletion or exon 21 L858R mutation); ② Second line treatment for EGFR T790M mutation positive NSCLC patients.
1、 Specific indications and clinical basis
1. Frontline treatment for EGFR sensitive mutation patients
Fumatinib is approved for the initial treatment of EGFR sensitive mutation positive advanced NSCLC. Clinical studies, such as the FURLONG trial, have shown that its progression free survival (PFS) is significantly better than first generation EGFR-TKI drugs, and it has a higher control rate for central nervous system metastases.
2. Second line treatment for EGFRT790M mutation patients
For patients who experience disease progression after receiving first or second-generation EGFR-TKI treatment and have been confirmed to have T790M resistance mutations through testing, fumatinib is the standard treatment option. Research data shows that its objective response rate (ORR) and median PFS are both excellent.
3. Treatment of patients with brain metastases
Fumatinib penetrates the blood-brain barrier and has significant therapeutic effects on brain metastases. Clinical studies have observed a reduction or stabilization of intracranial lesions, providing an important treatment option for NSCLC patients with concomitant brain metastases.
2、 Medication precautions
1. The necessity of genetic testing: Before use, it is necessary to confirm the EGFR mutation status, especially T790M mutation, through tissue or liquid biopsy.
2. Safety: Common adverse reactions include diarrhea, rash, liver dysfunction, etc., but overall tolerability is good, mostly at level 1-2.
3. Drug resistance management: If disease progression occurs during treatment, the gene mutation spectrum needs to be reassessed to adjust subsequent plans.
