What are the discontinuation criteria for tucatinib/tucatinib?

In the management of targeted therapy, when to stop the drug is a matter of great concern to both patients and doctors. For tucatinib/tucatinib (Tucatinib), its discontinuation principles are relatively clear in international medication instructions and overseas clinical practice. The core standard is to continue treatment until disease progression or unacceptable toxic reactions occur.

From a treatment logic point of view, tucatinib is a long-term control drug targeting theHER2 signaling pathway, not a short-term treatment. As long asbreast cancer and colorectal cancerpatients can still obtain disease control from the treatment and the overall tolerance is good, it is usually not recommended to actively discontinue the drug due to"longer medication time". Overseas cancer treatment concepts place more emphasis on maintaining the continuity of treatment to delay disease progression and maintain quality of life.

Disease progression is the most common and clearest indication for discontinuation. When imaging evaluation or clinical manifestations indicate clear tumor progression, it means that the current treatment regimen is no longer able to effectively inhibit tumor growth. At this time, the continued use of tucatinib is of limited significance. The treatment strategy needs to be adjusted in a timely manner and transferred to other systemic treatments or clinical research pathways.

Another important discontinuation criterion is the occurrence of unacceptable toxicity. Although tucatinib has high selectivity for HER2 and is safer than some pan-HER inhibitors, it may still cause adverse reactions such as diarrhea and abnormal liver function. When these reactions cannot be improved after dose adjustment or symptomatic treatment, or have a significant impact on the patient's quality of life, drug discontinuation is a reasonable and necessary option.

It is worth emphasizing that transient side effects do not equate to discontinuation of medication. In overseas practices, doctors often prioritize managing adverse effects through dose reduction, drug suspension, or supportive care rather than immediate and permanent discontinuation. The decision to discontinue a drug is made only when the risks clearly outweigh the potential benefits.

Therefore, discontinuation of tucatinib is not determined by a fixed course of treatment, but is based on a comprehensive assessment of disease control status and individual tolerability.

Reference materials:https://www.tukysa.com/