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Updated: Jul 17, 2026
Pre-clinical Evaluation of Tyrosine Kinase Inhibitors for Treatment of Acute Leukemia
Published on: September 18, 2013
Efficacy on symptoms and mortality day vs. night administration of EGFR-TKIs for advanced non-small cell lung cancer
Onam Ok1, Mangyeong Lee2,3, Nayeon Kim1,2,4
1Department of Nursing, Graduate School of Clinical Nursing Science, Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea.
Purpose:
This study has a purpose to investigate the side effects of three EGFR-TKIs targeted therapeutic agents (gefitinib, erlotinib, and afatinib) and all-cause mortality in patients with metastatic lung cancer.
Methods:
We performed a prospective cohort study. We selected all patients with newly diagnosed metastatic lung cancer between January and November 2019. Main exposure was daytime versus nighttime use of targeted EGFR TKIs. The study outcome was a symptom change using the mobile application, and all-cause mortality between January 2019 and March 2023.
Results:
Among the 87 study participants, 35 (40%) took their medication at night. Among the 87 study participants, 35 (40%) took their medication at night. At 6 weeks of treatment, acne (1.36; 95% confidence interval [CI] 1.09, 1.64; p for interaction = 0.04) and dry skin (1.35; 95% CI 1.09, 1.61, p for interaction = 0.01) in the day group showed a much increase from baseline compared to the night group. In contrast, the night group reported greater reductions in lung cancer-related symptoms from baseline compared to the day. During follow-up (median 43 months), the night group had a lower risk of all-cause death than the day group, especially in younger patients (adjusted hazard ratio = 0.34; 95% CI 0.13, 0.87).
Conclusions:
The group taking EGFR-TKIs at night experienced fewer side effects and had longer overall survival compared to the day group. Clinicians should consider recommending that lung cancer patients take their once-daily oral anticancer drugs in the evening rather than the morning to improve treatment outcomes.
Insights
Taking EGFR-TKIs at night reduced side effects and improved survival in metastatic lung cancer patients. This timing strategy may enhance treatment outcomes for lung cancer therapy.
Area of Science:
- Oncology
- Pharmacology
- Clinical Medicine
Background:
- Metastatic lung cancer requires effective targeted therapies.
- Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors (EGFR-TKIs) are crucial in treating specific lung cancers.
- Optimizing the administration schedule of oral EGFR-TKIs may improve patient outcomes.
Purpose of the Study:
- To investigate the impact of daytime versus nighttime administration of EGFR-TKIs on side effects.
- To assess the effect of EGFR-TKI timing on all-cause mortality in metastatic lung cancer patients.
Main Methods:
- A prospective cohort study was conducted with 87 newly diagnosed metastatic lung cancer patients.
- Exposure was defined as daytime versus nighttime intake of oral EGFR-TKIs (gefitinib, erlotinib, afatinib).
- Symptom changes were monitored via a mobile app, and all-cause mortality was tracked over a median of 43 months.
Main Results:
- Nighttime EGFR-TKI administration was associated with significantly fewer skin-related side effects (acne, dry skin) compared to daytime use.
- Patients taking EGFR-TKIs at night reported greater reductions in lung cancer-related symptoms.
- The nighttime group exhibited a lower risk of all-cause mortality, particularly in younger patients.
Conclusions:
- Administering EGFR-TKIs in the evening may mitigate side effects and improve overall survival in metastatic lung cancer.
- Clinicians should consider evening dosing for once-daily oral anticancer drugs to enhance treatment efficacy and patient quality of life.
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