Treatment of Advanced NSCLC with Unknown EGFR Gene Status __ TKI or Chemotherapy?

At present, the treatment recommendations of advanced non-small cell lung cancer (NSCLC) with clear epidermal growth factor receptor (EGFR) gene status has reached a consensus: patients with EGFR mutation-positive NSCLC can give priority to epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs), which can maximize the benefit from the treatment; while the patients with wild-type EGFR gene should regard chemotherapy as first choice whether the first-line or second-line therapy. A large proportion of patients, however, have not received EGFR gene test for various reasons. In the paper, we will thoroughly review the related clinical trial from the point of view of evidence-based medicine, and suggest that the treatment of advanced NSCLC with unknown EGFR gene status should be distinguished according to their race and pathological characters in order to find out the patients who are most likely to benefit from EGFR-TKIs, and thus arrange the treatment sequence scientifically and rationally.