Discontinuing epidermal growth factor receptor-tyrosine kinase inhibitor during second-line chemotherapy: is the evidence strong enough?

Dr. Soria et al. reported an important randomized controlled trial showing that continuation of gefitinib after radiological disease progression on first-line gefitinib did not prolong progression-free survival (PFS) in patients who received pemetrexed plus cisplatin chemotherapy as subsequent line of treatment (1). This study clarified some previous controversies on the management strategy of patients who progressed after epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) treatment. However, some concerns remain.