A Prospective Multicenter Study of the Association Between TCM Syndromes and EGFR-TKI Efficacy in Lung Cancer Patients

• EGFR-TKI (Drug): Standard treatment with EGFR tyrosine kinase inhibitors (e.g., gefitinib, erlotinib, osimertinib) for NSCLC. The study observes its association with TCM syndrome patterns.

Primary outcomes

• Progression-Free Survival [From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 3 years.]: Progress free survival defined as the time from first dose of study treatment until the first date of either objective disease progression or death due to any cause.
• Disease-Free Survival [From the date of surgery until the date of first documented tumor recurrence, distant metastasis, or death from any cause, assessed up to 5 years.]: From the date of surgery until the date of first documented tumor recurrence, distant metastasis, or death from any cause, whichever occurs first.

Secondary outcomes

• Objective Response Rate [Through study completion, an average of 3 years.]: Objective response rate is defined as the proportion of patients achieving complete (CR) or partial (PR) response according to RECIST V.1.1 criteria.
• Disease Control Rate [Through study completion, an average of 3 years.]: Disease control rate is determined by the percentage of patients who achieve CR, PR, or SD as defined by RECIST V.1.1 criteria. This encompasses all instances of CR, PR, and SD (CR + PR + SD).
• Overall Survival [From the date of randomization until the date of death from any cause, assessed up to 5 years.]: Overall survival is defined as the time until death due to any cause.
• Quality of life evaluation [At the baseline, every 3 months until disease recurrence/progression or the end of the study, assessed up to 3 years.]: According to the requirements of European Organisation for Research and Treatment of Cancer-quality of life core questionnaire (EORTC QLQ-C30)/Lung cancer 29 items (LC 29), the scoring results of each field of the scale were recorded in CRF. The score of this questionnaire ranges between 1 and 4. The higher score indicates the worse quality of life.
• Traditional Chinese Medicine Symptom Assessment [At the baseline, every 3 months until disease recurrence/progression or the end of the study, assessed up to 3 years.]: According to the requirements of the MDASI-TCM scale, the scores of each domain were recorded in the CRF. Each item is rated on a numeric scale ranging from 0 to 10, with higher scores indicating greater symptom severity or symptom interference.

Other outcomes

• Traditional Chinese Medicine (TCM) Syndrome Classification [At the baseline, every 3 months until disease recurrence/progression or the end of the study, assessed up to 3 years.]: Tongue and pulse characteristics will be collected using standardized and validated tongue diagnosis and pulse diagnosis devices. Standardized symptom information (e.g., fatigue, poor appetite) will be collected by licensed TCM practitioners. Symptoms will be recorded as present or absent without severity grading. Based on tongue, pulse, and symptom information, TCM practitioners will determine and classify each participant's TCM syndrome pattern (e.g., cold syndrome, heat syndrome) at each assessment time point.

Sex: All, ages: 18 Years to any

Inclusion Criteria:

* Pathologically or histologically confirmed non-small cell lung cancer (NSCLC)
* Age ≥ 18 years
* Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2
* Presence of epidermal growth factor receptor (EGFR) mutation confirmed by genetic testing

Postoperative Cohort (must meet all of the above and the following):

* Have undergone curative surgery for lung cancer with R0 resection
* Are planned to receive or are currently receiving postoperative EGFR-TKI adjuvant therapy within 2 weeks

Advanced Cohort (must meet all of the above and the following):

* Meet stage IIIB-IV criteria according to the 9th edition of the American Joint Committee on Cancer (AJCC), or have stage IIIB or below disease but have refused or are unable to tolerate surgical treatment
* Have at least one measurable lesion
* Are planned to receive or are currently receiving first-line EGFR-TKI therapy within 2 weeks

Exclusion Criteria:

* Unable to comply with baseline assessments
* Pregnant or breastfeeding women
* Presence of other uncontrolled malignancies
* Presence of severe brain diseases or psychiatric disorders that affect the patient's ability to communicate or provide informed consent
* Individuals without legal capacity, or those with medical or ethical reasons preventing continued participation in the study
* Refusal to sign the informed consent form