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Updated: May 24, 2025

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Dose Reduction of EGFR-TKIs for EGFR-positive Non-small Cell Lung Cancer: A Retrospective Study

Akira Mochizuki1, Hiroaki Matsumoto2, Yosuke Maezawa2

  • 1Division of Hospital Pharmacy, Mito Medical Center, University of Tsukuba-Mito Kyodo General Hospital, Mito, Japan.

Cancer Diagnosis & Prognosis
|March 4, 2025
PubMed
Abstract

Insights

Reducing epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) doses in non-small cell lung cancer (NSCLC) patients is a viable option. Dose reduction, often due to side effects, was associated with longer overall survival in EGFR-mutated NSCLC.

Area of Science:

  • Oncology
  • Pharmacology
  • Genetics

Background:

  • Epidermal growth factor receptor (EGFR) mutations drive non-small cell lung cancer (NSCLC).
  • EGFR tyrosine kinase inhibitors (TKIs) have improved NSCLC prognosis.
  • Conventional dosing strategies are unsuitable for EGFR-TKIs.

Purpose of the Study:

  • To characterize patients requiring EGFR-TKI dose reduction.
  • To assess the impact of EGFR-TKI dose reduction on survival outcomes in NSCLC.

Main Methods:

  • Retrospective evaluation of 165 EGFR-mutated NSCLC patients treated with EGFR-TKIs.
  • Analysis of patient characteristics, treatment details, and survival data.
  • Multivariate analysis to identify factors influencing survival.

Main Results:

  • 67.3% of patients underwent EGFR-TKI dose reduction, often due to side effects like diarrhea and rash.
  • Patients receiving dose reduction had smaller body surface area and better performance status.
  • Overall survival was significantly longer in the dose reduction group (p=0.011).
  • Multivariate analysis identified TKI dose reduction as a favorable prognostic factor (HR=0.68, p=0.046).

Conclusions:

  • EGFR-TKI dose reduction is a practical approach for managing adverse effects in EGFR-mutated NSCLC.
  • Dose reduction can be safely implemented, particularly in elderly or underweight patients.
  • Consider dose reduction without hesitation for patients experiencing adverse events.
Keywords:
EGFR mutationEGFR-TKINon-small cell lung cancerdose reductionosimertinib

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