Dr. Kelly on Determining Second-Line TKI in Lung Cancer

Karen Kelly, MD, associate director for clinical research, University of California (UC) Davis Comprehensive Cancer Center, professor of medicine, UC Davis Health, discusses how to determine treatment after patients with lung cancer progress on TKIs.

Patients receiving TKIs for lung cancer have a range of progression-free survival (PFS) achieved; an exceptional PFS for patients on ALK inhibitors is around 35 months, according to Kelly. Although patients enjoy a prolonged PFS provided by TKIs compared with chemotherapy, all patients eventually fail their TKI due to developed resistance, explains Kelly.

When patients fail their TKI, it is important to determine why. Kelly’s goal when treating patients with TKIs is to keep them on a TKI as long as possible, whether that be in the first- or second-line setting. When choosing a TKI for the second-line setting, Kelly suggests gathering information from a tissue or liquid biopsy to help guide selection for a TKI.

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