Reduced TKI starting dose on par with standard dose for NSCLC

Initiating tyrosine kinase inhibitor (TKI) therapy at a reduced dose appears to result in progression-free survival (PFS) and 15-month survival outcomes comparable to TKI therapy at the Food and Drug Administration (FDA) standard dose, reports a study.

“Epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) TKIs can cause intolerable adverse events in patients with nonsmall cell lung cancer (NSCLC) and may be prescribed at a lower dose,” the authors said.

A retrospective chart review was conducted with patients on EGFR and ALK TKIs for NSCLC. Patients were categorized in two groups: those initiated on FDA standard dose and those initiated on a reduced dose. The authors then compared PFS, overall survival (OS), and other treatment outcomes between the two groups.

Ninety patients were analysed, of which 67 belonged to the standard dose group and 23 to the reduced dose group. The median time-to-progression was 13.4 months (95 percent confidence interval [CI], 8.9–15.6) for the standard dose group and 15.1 months (95 percent CI, 5.6–21.5) for the reduced dose group. The median time-to-death was not calculable for OS.

The predicted OS probability at approximately 15 months following treatment initiation was 81.8 percent and 80.5 percent for the standard and reduced dose groups, respectively.

The results showed that patients who initiated TKI therapy at a reduced dose did not have different PFS and 15-month survival outcomes than those who initiated TKI therapy at the FDA standard dose, according to the authors.