Abstract:

Objective To evaluate the efficacy of epidermal growth factor receptor tyrosine kinase inhibi⁃ tor（EGFR⁃TKI）on miliary lung cancer，and to explore the immunophenotyping of tumor microenvironment（TME） and its correlation with the effect of EGFR⁃TKI. Methods We retrospectively analyzed 147 patients with stage IV non ⁃ small cell lung cancer（NSCLC）who had EGFR mutation and received EGFR ⁃TKI treatment in Guangzhou Chest Hospital from March 2017 to March 2019. According to imaging diagnosis，the patients were divided into miliary lung cancer group（group A，n = 49）and non⁃miliary lung cancer group（group B，n = 98）. The efficacy of targeted therapy was compared between the two groups，and the immunophenotyping of TME and its relationship with the efficacy of EGFR ⁃ TKI were analyzed. Results The positive rates of PD ⁃ L1 and CD8 in group A were 40.82% and 53.06%，respectively，which were significantly higher than those in group B（24.49% and 29.59%）. In group A，the median progression⁃free survival time（PFS）of patients with type I TME was significantly worse than that of type Ⅱ/Ⅲ/Ⅳ（5.7 months vs. 7.4 months，P = 0.024）；the same was true in group B（6.0 months and 11.0 months，P = 0.027）. Conclusion Patients with miliary lung cancer benefit poorly from EGFR⁃TKI. The 

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