EGFR testing should be done for second-line treatment of non-small cell lung cancer. EGFR-TKI can be chosen for EGFR mutation, and chemotherapy can be chosen for EGFR wild type. When second-line drug selection is done for non-small cell lung cancer, Lipitor is associated with histological type, and Erlotinib and Gefitinib are associated with EGFR mutation status. Many faculty members will pay special attention to the superior population of TKI’s when using EGFR-TKI drugs. The famous IPASS study, which was based on a clinically selective population, showed retrospectively that even in the adenocarcinoma, nonsmoking, Asian predominant population, more than 40% of patients were free of EGFR mutations. Nearly half of the patients in the predominant population were EGFR wild-type patients. For these EGFR wild-type patients, then, the effectiveness of using TKI is only 1.1%, which means that EGFR wild-type patients do not benefit from TKI treatment and should be treated with more effective chemotherapy. A series of clinical studies that prospectively screened patients based on EGFR mutations have emerged, further clarifying that EGFR mutations are the predictors of effective EGFR-TKI therapy. EGFR-TKI therapy requires the selection of patients with EGFR mutations. After reviewing the results of the IPASS study, let’s take a look at the Interest study, a head-to-head comparison study on second-line chemotherapy versus TKI that once again validates that patients with EGFR wild-type do not benefit from second-line TKI therapy, and that the PFS of gefitinib in EGFR wild-type patients was only 1.7 months, much lower than its PFS in mutated patients, such a huge difference tells us that patients with EGFR wild type do not benefit from TKI therapy. Looking again at the remission rates of TKI in second-line therapy, both the INTEREST and ISEL studies involving gefitinib and the BR21 study of erlotinib show that the objective remission rates of TKI treatment in EGFR wild-type patients are much lower than in mutant patients. It is because of this that the EU does not approve gefitinib for the treatment of EGFR wild-type patients and requires that the mutation status of EGFR be clarified before TKI drugs can be used. The TAILOR study, reported by Professor Garassino at this year’s ASCO Congress, gives us a direction: patients with EGFR wild-type should opt for chemotherapy! The phase III clinical study enrolled patients with advanced NSCLC who had previously progressed on platinum-containing two-drug chemotherapy, were EGFR wild-type, had an ECOG score of 0-2, and were randomized 1:1 to the chemotherapy and EGFR-TKI groups for second-line treatment. The results showed that the median PFS was 3.4 months in the chemotherapy group represented by docetaxel and only 2.4 months in the TKI group represented by erlotinib, and the 6-month disease-free progression rate: 28.9% in the chemotherapy group and only 16.9% in the TKI group, with a statistically significant reduction in the risk of disease progression of 31% in the chemotherapy group compared to the TKI treatment group. We can see that chemotherapy treatment of EGFR wild-type patients significantly improved PFS compared to TKI. A subgroup analysis of the TAILOR study based on factors such as PS score, histological type, gender, and smoking status showed that most subgroups of patients had better PFS with chemotherapy than the TKI treatment group. The objective remission rate of 13.9% in the chemotherapy group was significantly better than that of 2.2% in the TKI group, and the disease control rate of 41.5% in the chemotherapy group was also significantly better than that of 22.8% in the TKI group. The efficacy of chemotherapy for EGFR wild-type patients was significantly better than that of TKI treatment in terms of PFS, ORR rate and DCR rate.