Study aid only. Verify against current guidelines, primary literature, staging manuals, and prescribing information before clinical use.

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EGFR-Mutant Stage IV NSCLC — Systemic Therapy

First-line Later-line THIRD-LINE / LATER EGFR-mutant stage IV NSCLC Common ex19 / L858R Exon 20 insertion Atypical Post-osimertinib Preferred Osimertinib FLAURA ↗ CNS Intensified Chemo + osimertinib FLAURA2 ↗ Chemo-free Amivantamab + lazertinib MARIPOSA ↗ CNS Targeted Amivantamab + chemo PAPILLON ↗ TKI Sunvozertinib exon 20-selective TKI Afatinib or osimertinib context-dependent ↗ Targeted Amivantamab + chemo MARIPOSA-2 ↗ ADC Datopotamab deruxtecan TROPION LUNG 01 ↗ Cytotoxic Docetaxel ± ramucirumab REVEL ↗