What is the best drug as a front-line treatment for EGFR activating mutation?

The landscape of lung cancer treatment is dramatically changing. Non-small cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutations are associated with a therapeutic response to tyrosine kinase inhibitors (TKIs). EGFR-inhibiting agents, including first-, second-, and third-generation drug are now available for patients with EGFR mutation-positive NSCLC. However, their clinical impact may differ in such individuals. Physicians now need to consider how to use these drugs to provide the best chance of a long-term survival. This mini-review discusses intratumor heterogeneity, outcomes of head-to-head trials of EGFR-TKIs, the effect of uncommon/compound EGFR mutations, and the current provisions for first-line treatment and perspectives regarding molecular target drug for patients with EGFR mutation putting into focus of second-generation EGFR-TKI.