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Research progress on criteria for discontinuation of EGFR inhibitor therapy
Hong-Qing Zhuang1, Zhi-Yong Yuan, Jun Wang
1Department of Radiotherapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin Lung Cancer Center, Tianjin, People's Republic of China.
Abstract:
The clinical success of the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI) as therapeutic agents has prompted great interest in their further development and clinical testing for a wide variety of malignancies. However, most studies have focused on the efficacy of TKI, and few studies have been done on the criteria for their discontinuation. The current standard for drug discontinuation is "until progression", based on change in tumor size. However, tumor size is not related to the gene expression which determines the efficacy of TKI in the final analysis, and it is also difficult to make a thorough and correct prediction based on tumor size when the TKI is discontinued. Nevertheless, clinical evaluation of the criteria for TKI discontinuation is still in its early days. Some promising findings have started to emerge. With the improving knowledge of EGFR and its inhibitors, it is expected that the criteria for discontinuation of EGFR inhibitor therapy will become clearer.
Insights
Clinical success of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI) is notable, yet criteria for discontinuing TKI therapy require further research beyond tumor size. Emerging findings suggest clearer discontinuation guidelines are forthcoming.
Area of Science:
- Oncology
- Pharmacology
- Molecular Biology
Background:
- Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI) demonstrate significant clinical success in treating various cancers.
- Current research predominantly focuses on TKI efficacy, with limited investigation into optimal discontinuation criteria.
Purpose of the Study:
- To highlight the need for improved criteria for discontinuing EGFR tyrosine kinase inhibitor therapy.
- To address the limitations of the current "until progression" standard based on tumor size.
Main Methods:
- Review of existing clinical practices and emerging research on TKI discontinuation.
- Analysis of the relationship between gene expression, TKI efficacy, and treatment cessation.
Main Results:
- The standard "until progression" criterion based on tumor size is insufficient for predicting TKI effectiveness or guiding discontinuation.
- Tumor size does not correlate with the gene expression that ultimately determines TKI efficacy.
Conclusions:
- Clinical evaluation of TKI discontinuation criteria is in its nascent stages.
- Advancements in understanding EGFR and its inhibitors are expected to yield clearer guidelines for therapy cessation.
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