D resistance has been an emerging issue even in responsive sufferers. As a result, several efforts happen to be produced to investigate the clinical outcomes of this acquired resistance group and overcome resistance. Techniques to overcome acquired resistance to EGFR TKIs involve resumed EGFR TKI use, new-generation irreversible EGFR TKI use, MET inhibitor use for MET amplification, and use of PI3K/AKT/mTOR inhibitor plus MEK inhibitor (18-21, 26). The clinical trial outcomes for the new-generation irreversible TKI afatinib had been reported. The Lux-Lung1 study incorporated lung adenocarcinoma patients who had received 1 or 2 prior chemotherapy regimens and experienced illness progression just after 12 weeks of erlotinib or gefitinib therapy.http://jkms.orgKim H, et al. Survival soon after Progression on GefitinibTable 3. Post-progression survival analysis Univariate evaluation Variables Age (yr) Gender Smoking Histology ECOG PS Initial stage Numbers of metastatic organs Gefitinib timing Resuming TKIs PBC just after gefitinib Pemetrexed just after gefitinib Docetaxel right after gefitinib Irinotecan immediately after gefitinib Gemcitabine soon after gefitinib Vinorelbine just after gefitinib PFS for 1st gefitinib Variety of total chemotherapy lines Category 65 (n = 56) 65 (n = 25) Female (n = 63) Male (n = 18) Never (n = 59) Ever (n = 22) ADC (n = 77) non-ADC (n = four) 0-1 (n = 59) two (n = 22) IIIB (n = 7) IV (n = 74) three (n = 50) three (n = 31) 1st line (n = 33) 2nd line (n = 48) Ever (n = 16) Under no circumstances (n = 65) Ever (n = 32) By no means (n = 49) Ever (n = 28) Never ever (n = 53) Ever(n = 20) Under no circumstances (n = 61) Ever (n = 22) By no means (n = 59) Ever (n = 36) In no way (n = 45) Ever (n = 34) By no means (n = 47) ten months (n = 44) 10 months (n = 37) 4th line (n = 31) 4th line (n = 50) Median PPS months (95 CI) 11.three (7.5-15.0) eight.2 (six.8-9.six) 10.1 (4.1-17.1) ten.six (7.3-12.eight) 10.7 (7.2-14.1) 8.1 (three.9-12.2) 10.3 (7.5-13.0) 8.0 (0.0-25.three) 11.three (8.3-14.three) five.six (0.0-11.6) 18.3 (5.5-31.0) ten.0 (7.7-12.two) 12.0 (8.5-15.4) 8.2 (five.0-11.4) 13.five (7.4-19.6) eight.0 (4.8-11.2) 27.four (19.2-35.5) eight.eight (six.6-11.0) 13.three (4.2-22.four) eight.two (five.8-10.7) 18.five (0.0-37.1) 8.6 (5.6-11.six) 18.5 (five.2-31.7) 8.1 (six.1-10.1) 11.7 (1.9-21.6) 10.0 (7.2-12.eight) 13.three (0.79-25.9) 8.2 (five.8-10.7) 13.3 (4.6-4.3) 8.6 (six.4-10.8) 10.7 (four.5-16.9) 10.1 (7.4-12.7) 21.6 (14.7-28.5) 7.0 (four.3-9.eight) HR (95 CI) 0.64 (0.39-1.05) 1.00 0.80 (0.47-1.37) 1.00 0.65 (0.39-1.07) 1.00 0.76 (0.24-2.42) 1.00 0.76 (0.45-1.27) 1.00 0.58 (0.25-1.34) 1.00 0.Fmoc-Thr(tBu)-OH Autophagy 53 (0.NNK Endogenous Metabolite 33-0.PMID:28739548 85) 1.00 0.55 (0.34-0.89) 1.00 0.41 (0.22-0.75) 1.00 0.71 (0.45-1.12) 1.00 0.36 (0.21-0.62) 1.00 0.56 (0.33-0.94) 1.00 0.76 (0.45-1.26) 1.00 0.51 (0.32-0.82) 1.00 0.57 (0.36-0.92) 1.00 0.91 (0.58-1.44) 1.00 0.46 (0.28-0.74) 1.00 P 0.076 0.414 0.090 0.644 0.298 0.204 0.009 0.014 0.004 0.143 0.001 0.029 0.281 0.005 0.021 0.685 0.001 0.61 (0.29-1.32) 1.00 0.209 0.93 (0.18-3.74) 1.00 0.44 (0.09-2.19) 1.00 0.930 0.316 0.45 (0.25-0.81) 1.00 0.72 (0.32-1.64) 1.00 0.008* 0.437 0.62 (0.37-1.02) 1.00 0.52 (0.28-0.95) 1.00 0.53 (0.25-1.12) 1.00 0.061 0.035* 0.095 0.91 (0.51-1.61) 1.00 0.741 Multivariate evaluation HR (95 CI) 0.58 (0.32-1.07) 1.00 P 0.Tested by Cox proportional hazards model; *Statistically important; ECOG at the begin of gefitinib; Staging as outlined by the revised International Method for Staging Lung Cancer. HR, hazard ratio; CI, confidential interval; ADC, adenocarcinoma; ECOG, Eastern Cooperative Group; PS, efficiency status; TKI, tyrosine kinase inhibitor (gefitinib and erlotinib); PBC, platinum-based chemotherapy.The results showed that afa.