Stop EGFR-Targeted TKIs at Progression in NSCLC
Contrary to a clinical practice that some oncologists have been using to prevent disease flares when withdrawing tyrosine kinase inhibitors (TKIs) in patients with NSCLC, updated results from the IMPRESS trial, first published in The Lancet Oncology in 2015, demonstrate that continuing the TKI alongside chemotherapy may be detrimental. In that trial, placebo was superior to gefitinib (hazard ratio = 1.44; P = .016) when they were continued along with cisplatin plus pemetrexed. Tony S.K. Mok, MD, Professor and Chairman of the Department of Clinical Oncology at the Chinese University of Hong Kong, said, “…there is one important message in patients with EGFR-mutated NSCLC: When you need to move to a chemotherapy at the time of progression, then you should stop the TKI.”
