• Xin Li, Han Qi, Gou Qing, Ze Song, Lin Xie, Fei Cao, Xiaoming Chen, and Weijun Fan.
• Department of Medical Oncology, Affiliated Xiaolan Hospital, Southern Medical University, Guangzhou, China.
• Thorac Cancer. 2018 Aug 1; 9 (8): 1012-1017.

BackgroundAlthough patients with EGFR-mutant non-small-cell lung cancer (NSCLC) benefit from treatment with EGFR-tyrosine kinase inhibitors (TKIs), outcomes are limited by the eventual development of acquired resistance. We conducted a retrospective study to evaluate the efficacy and feasibility of EGFR-TKI therapy beyond focal progression, associated with microwave ablation.MethodsPatients with metastatic EGFR-mutant NSCLC treated with EGFR-TKIs at our institutions from May 2012 to December 2017 were identified. Patients with single lesion progression, treated with MWA, and continually administered EGFR-TKI therapy until further progression, were included in the study. Initial response to target therapy, median progression-free survival (PFS1), and first progression site were recorded. The median time to progression after local therapy (PFS2) was also assessed. Overall survival was calculated from the initiation of EGFR-TKIs to the date of final follow-up or death.ResultsFifteen out of 205 patients (10%) satisfied the inclusion criteria. Local therapy was well tolerated, and complete ablation was performed in 11 (73.3%) patients. The median PFS1 was 9.5 months (range 6-41), and the median PFS2 was 8 months (range 3-24). The corresponding 6 and 12 month PFS rates were 73.3% and 26.7%, respectively. Median overall survival was 23 months (range 15-64).ConclusionThe longer disease control observed in our patients suggests that continuation of EGFR-TKI beyond focal progression associated to microwave ablation is an efficacious therapeutic strategy.© 2018 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.

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