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vinorelbine + AST2818 (vinorelbine + firmonertinib) is an all-oral combination regimen consisting of the semi-synthetic vinca alkaloid vinorelbine and the third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) firmonertinib (AST2818). Vinorelbine acts as a microtubule inhibitor, disrupting mitotic spindle assembly to induce cell cycle arrest and apoptosis. Firmonertinib is an irreversible, covalent inhibitor that selectively targets both EGFR-sensitizing mutations (such as exon 19 deletions and L858R) and the T790M resistance mutation while sparing wild-type EGFR. This combination is being evaluated as a first-line treatment for patients with refractory EGFR-mutated advanced non-small cell lung cancer (NSCLC), particularly those with M1c2 disease or elevated PD-L1 expression, to provide a convenient, tolerable, and effective chemotherapy-sparing oral regimen.
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