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ORIGINAL RESEARCH ARTICLE

EGFR tyrosine kinase inhibitors plus bevacizumab for advanced non-small cell lung cancer with concurrent alterations: A retrospective study

Ling Zhou1† ,  Xiaojun Yang1† ,  Xiumao Yin1 ,  Wan Zhang1 ,  Qinquan Tan1 ,  Yihong Zeng1 ,  Yanmin Cai1 ,  Haiji Yuan1 ,  Jia Chen2 ,  Weidong Liu3* ,  Guanming Jiang1*
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1 Cancer Center, Dongguan Key Laboratory of Precision Diagnosis and Treatment for Tumors, The Tenth Affiliated Hospital, Southern Medical University, Dongguan, Guangdong, China
2 Research Center for Healthcare Data Science, Zhejiang Lab, Hangzhou, Zhejiang, China
3 Dongguan Innovation Institute, Guangdong Medical University, Dongguan, Guangdong, China
†These authors contributed equally to this work.
EJMO, 026060066 https://doi.org/10.36922/EJMO026060066
Received: 4 February 2026 | Revised: 7 March 2026 | Accepted: 6 May 2026 | Published online: 10 June 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Introduction: Patients with advanced non-small cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutations and concurrent genetic alterations often face a poor prognosis and limited response to standard therapies.

Objective: To evaluate and compare the efficacy and safety of EGFR tyrosine kinase inhibitors (EGFR-TKIs) in combination with bevacizumab versus EGFR-TKI monotherapy in patients with EGFR-mutant advanced NSCLC harboring concurrent genetic alterations.

Methods: In this retrospective single-center study, clinical data from 52 patients treated between January 2017 and June 2021 were reviewed. The primary endpoint was progression-free survival (PFS). Secondary endpoints included overall survival (OS), objective response rate, and safety.

Results: Among the 52 patients included, the median PFS was 10.50 months in the combination group (n = 22) and 7.00 months in the monotherapy group (n = 30), with no statistically significant difference between groups (p = 0.099). The 6-month PFS rate was higher in the combination group (81.8% vs. 53.3%, p = 0.03). Exploratory subgroup analyses suggested improved PFS with combination therapy in patients with L858R mutations (p = 0.016) and TP53 co-mutations (p = 0.034), though the baseline L858R distribution was imbalanced between groups (p = 0.015). No statistically significant difference in OS was detected. Grade ≥3 adverse events were more frequent in the combination group (27.3% vs. 3.3%).

Conclusion: EGFR-TKI plus bevacizumab did not significantly prolong PFS in the overall population compared to monotherapy. While potential benefits were observed in L858R and TP53 subgroups, the findings are constrained by the limited sample size and imbalances in baseline characteristics. The combination therapy showed increased but manageable toxicity. Larger, prospective studies are needed to validate these subgroup findings.

Keywords
EGFR mutation
Concurrent genetic alterations
Epidermal growth factor receptor tyrosine kinase inhibitors
Bevacizumab
Non-small cell lung cancer
Funding
This research was funded by the Dongguan Social Science and Technology Development (Key) Project (2022) (grant number: 20221800906342).
Conflict of interest
The authors declare no conflicts of interest.
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Eurasian Journal of Medicine and Oncology, Electronic ISSN: 2587-196X Print ISSN: 2587-2400, Published by AccScience Publishing
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