AI Article Synopsis

  • Some patients with advanced EGFR mutation-positive non-small-cell lung cancer can continue treatment with EGFR tyrosine kinase inhibitors (TKIs) even after their cancer shows signs of progression according to radiological assessments.
  • A study of 577 patients revealed that a significant portion remained clinically stable despite radiological progression, with many continuing TKI therapy.
  • Continuing the treatment appeared to offer similar survival rates compared to those who discontinued, indicating that ongoing TKI therapy might benefit certain patient groups after initial signs of disease progression.

Article Abstract

Background: Some patients with advanced or recurrent, epidermal growth factor receptor (EGFR) mutation-positive (EGFR M+) non-small-cell lung cancer (NSCLC) continue to receive EGFR tyrosine kinase inhibitors (TKIs) beyond radiological progression.

Methods: We analysed a cohort of 577 patients with EGFR M+ NSCLC, who had received a first-line EGFR-TKI. We classified patients according to clinical course and treatment patterns at Response Evaluation Criteria in Solid Tumors (RECIST) progressive disease (PD). We evaluated the period from RECIST PD to TKI discontinuation or clinical PD and also evaluated survival after RECIST PD and compared it between groups.

Results: RECIST PD was documented in 451 cases, of which 283 (62.7%) were clinically stable. 186 (65.7%) discontinued and 97 (34.3%) continued the EGFR-TKI. In those who continued EGFR-TKI, median time between RECIST PD and clinical PD or TKI discontinuation was 5.1 months. Median survival after RECIST PD in patients who discontinued and continued EGFR-TKI after clinically stable RECIST PD was 14.6 and 15.3 months (p=0.5489), respectively. In multivariate analysis, continuing EGFR-TKI therapy, female gender, better performance status and exon 19 deletion subtype were likely positive predictive factors for survival after clinically stable RECIST PD.

Conclusion: Our study suggests that some patients could benefit from receiving an EGFR-TKI beyond radiological progression.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5604715PMC
http://dx.doi.org/10.1136/esmoopen-2017-000214DOI Listing

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