Immunotherapy after EGFR‑TKI treatment in advanced non‑small cell lung cancer: Current status and future perspectives (Review)

The tumor microenvironment (TME) of epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC) exhibits notable immunosuppressive properties.EGFR tyrosine kinase inhibitors (EGFR-TKIs) induce dynamic remodeling of the TME.By boosting the infiltration of immune cells such as T cells and dendritic cells and decreasing immunosuppressive elements such as tumor-associated macrophages and regulatory T cells, short-term TKI treatment can effectively enhance antitumor immunity.However, the TME changes to an immunosuppressive state marked by PD-L1 upregulation and immune escape with continued therapy and the emergence of resistance.This creates a transient immunotherapy window period during EGFR-TKI treatment, when immune checkpoint inhibitors may achieve optimal efficacy.It is essential to identify and take advantage of this window in order to enhance treatment results.The present review highlights the importance of understanding TME dynamics in EGFR-mutant NSCLC to optimize combination strategies and guide future therapeutic development.Contents 1. Introduction 2. Mechanisms of resistance to EGFR-TKIs 3. Tumor-infiltrating immune cells 4. Immunomodulatory molecules 5. Immunotherapy clinical trials in EGFR-mt advanced NSCLC 6. Discussion and future perspectives