{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T12:52:46Z","timestamp":1782478366947,"version":"3.54.5"},"reference-count":14,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,12,16]],"date-time":"2022-12-16T00:00:00Z","timestamp":1671148800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Thoracic Cancer"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Epidermal growth factor receptor\u2010tyrosine kinase inhibitors (EGFR\u2010TKIs) are standard treatments for advanced non\u2013small cell lung cancer (NSCLC) patients harboring the EGFR mutation. Patients experiencing intolerable adverse events (AEs) would discontinue EGFR\u2010TKIs. This study aimed to evaluate the impact of intolerable AEs and subsequent treatment on the survival of patients who discontinued EGFR\u2010TKIs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>The data of advanced NSCLC patients treated with EGFR\u2010TKIs as frontline treatment at Chang Gung Memorial Hospitals from June 2014 to March 2018 were retrospectively reviewed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 2190 patients were enrolled and treated with frontline EGFR\u2010TKIs. In August 2021, 114 (5.2%) patients experienced intolerable AEs requiring discontinuation of EGFR\u2010TKIs. The time median of EGFR\u2010TKIs discontinuation was 2.56\u2009months. Age &gt;65\u2009years, females, body weight, and body surface area were associated with the occurrence of intolerable AEs for patients treated with afatinib. Patients experiencing skin\/paronychia\/mucositis and abnormal liver function test had favorable survivals results. Patients who received subsequent EGFR\u2010TKIs treatment, experienced better progression\u2010free survival (PFS), total PFS (from frontline line EGFR\u2010TKIs), and overall survival (OS) compared to patients receiving chemotherapy or no treatment. Patients undergoing subsequent EGFR\u2010TKIs had better total PFS (median, 14.9 vs. 11.3\u2009months, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.013) and OS (median, 31.3 vs. 20.1\u2009months, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.001) than patients who did not discontinue because of AEs. Favorable OS was validated by propensity score matching.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients experiencing intolerable AEs during EGFR\u2010TKI treatment should consider switching to an alternative EGFR\u2010TKI, which increase the survival results as compared to those patients who did not experience intolerable AEs.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1759-7714.14674","type":"journal-article","created":{"date-parts":[[2022,12,16]],"date-time":"2022-12-16T18:51:51Z","timestamp":1671216711000},"page":"348-356","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The survival after discontinuation of <scp>EGFR\u2010TKIs<\/scp> due to intolerable adverse events in patients with <scp>EGFR<\/scp>\u2010mutated <scp>non\u2013small cell lung cancer<\/scp>"],"prefix":"10.1111","volume":"14","author":[{"given":"John Wen\u2010Cheng","family":"Chang","sequence":"first","affiliation":[{"name":"Division of Hematology\u2010Oncology, Department of Internal Medicine Chang Gung Memorial Hospital at Linkou  Taoyuan Taiwan"},{"name":"Chang Gung University College of Medicine  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ching\u2010Fu","family":"Chang","sequence":"additional","affiliation":[{"name":"Division of Hematology\u2010Oncology, Department of Internal Medicine Chang Gung Memorial Hospital at Linkou  Taoyuan Taiwan"},{"name":"Chang Gung University College of Medicine  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen\u2010Yang","family":"Huang","sequence":"additional","affiliation":[{"name":"Division of Hematology\u2010Oncology, Department of Internal Medicine Chang Gung Memorial Hospital at Linkou  Taoyuan Taiwan"},{"name":"Chang Gung University College of Medicine  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng\u2010Ta","family":"Yang","sequence":"additional","affiliation":[{"name":"Chang Gung University College of Medicine  Taoyuan Taiwan"},{"name":"Division of Thoracic Oncology, Department of Thoracic Medicine Chang Gung Memorial Hospital at Linkou  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih\u2010Hsi Scott","family":"Kuo","sequence":"additional","affiliation":[{"name":"Chang Gung University College of Medicine  Taoyuan Taiwan"},{"name":"Division of Thoracic Oncology, Department of Thoracic Medicine Chang Gung Memorial Hospital at Linkou  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yueh\u2010Fu","family":"Fang","sequence":"additional","affiliation":[{"name":"Chang Gung University College of Medicine  Taoyuan Taiwan"},{"name":"Division of Thoracic Oncology, Department of Thoracic Medicine Chang Gung Memorial Hospital at Linkou  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping\u2010Chih","family":"Hsu","sequence":"additional","affiliation":[{"name":"Chang Gung University College of Medicine  Taoyuan Taiwan"},{"name":"Division of Thoracic Oncology, Department of Thoracic Medicine Chang Gung Memorial Hospital at Linkou  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1081-8805","authenticated-orcid":false,"given":"Chiao\u2010En","family":"Wu","sequence":"additional","affiliation":[{"name":"Division of Hematology\u2010Oncology, Department of Internal Medicine Chang Gung Memorial Hospital at Linkou  Taoyuan Taiwan"},{"name":"Chang Gung University College of Medicine  Taoyuan 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