Abstract:Objective To explore the effects of the first generation of anti-epidermal growth factor receptor (EGFR) targeted drugs on the clinical efficacy of driver gene-positive non-small cell lung cancer (NSCLC) and on carcinoembryonic antigen (CEA),neuron-specific enolase (NSE),and cytokeratin 19 fragment (CY211). Methods From January 2017 to April 2019,112 patients with driver gene-positive NSCLC were treated and randomly divided into 4 groups (n=28,each).Based on gemcitabine combined with cisplatin chemotherapy performed in four groups,icotinib,domestic gefitinib,imported gefitinib and erlotinib were respectively given in icotinib group,domestic gefitinib group,imported gefitinib group and erlotinib group.After 3 months of treatment,the total efficiency,disease control rate,incidence of adverse reactions,serum levels of CEA,NSE,CY211,vascular endothelial growth factor (VEGF),basic fibroblast growth factor (bFGF) and angiopoietin 2 (Ang-2) were compared among 4 groups.All patients were followed up for 12 months,and the survival rate and progression-free survival were recorded. Results Three months after treatment,there were no significant differences in the total efficiency and disease control rate among four groups (P>0.05).Compared with those before treatment,the levels of CEA,NSE,CY211,VEGF,bFGF and Ang-2 decreased significantly after treatment in 4 groups(P<0.05).There was significant difference in the incidence of grade Ⅰ-Ⅱ rash among four groups,with the highest in erlotinib group (P<0.05)，but there was no significant difference in the incidence of other adverse reactions among 4 groups (P>0.05).After 12 months of follow-up,the survival rates were respectively 77.78% in icotinib group,67.86% in domestic gefitinib group,74.07% in imported gefitinib group and 69.23% in erlotinib group(P>0.05).There were no significant differences in progression free survival and in cost-effectiveness analysis among four groups (all P>0.05). Conclusion In the treatment of NSCLC patients with positive driver genes,the first generation of anti-EGFR targeted drugs can achieve good curative effect,reduce the serum levels of CEA,NSE and CY211 significantly,inhibit the formation of new blood vessels effectively,improve the 1-year survival rate of patients and prolong the progression-free survival period.The cost-effectiveness of erlotinib is better,but there is a higher incidence of rash in the patient using it.The appropriate drug can be selected according to the actual situation of patient.