Handbook of Lung Cancer and Other Thoracic Malignancies by Gregory P. Kalemkerian MD Jessica S. Donington MD Elizabeth M. Gore MD Suresh S. Ramalingam MD

Author:Gregory P. Kalemkerian, MD,Jessica S. Donington, MD,Elizabeth M. Gore, MD,Suresh S. Ramalingam, MD
Language: eng
Format: epub
Publisher: Springer Publishing Company, Inc.
Published: 2016-11-01T04:00:00+00:00

Slow progression

It is not uncommon to see slow progression of disease on repeat CT imaging at several month intervals. Although there is no formal definition of “slow progression,” it is typified by lesions that slightly enlarge over several months without progressive symptoms. This often occurs in patients with multiple, small, asymptomatic, intrapulmonary metastases that grow by a few millimeters every few months. It is important to remember that stage IV NSCLC is an incurable disease and that the goal of treatment is palliation of symptoms to promote quality-of-life and functionality. Since a subset of sensitive tumor clones may still be responding to the EGFR-TKI, the drug may be slowing disease progression. Therefore, an acceptable approach is to continue EGFR-TKI monotherapy despite slowly progressive disease with careful monitoring of symptoms (26–28).

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