| Benefits of continuing treatment |
Maintain stable disease or slow disease progression |
| Magnitude of tumor reduction |
If after an initial significant tumor response, a slow disease progression occurs, treatment may be continued as long as the clinical benefit is maintained |
| Size and location of tumor foci |
Evaluate risk of local complications if the tumor progresses |
| Feasibility of focal treatments |
In patients with dissociated responses, treatment may be maintained in those who progress in a single or in a few metastases that may benefit from focal treatment modalities. This may occur with bone metastases that progress and may then benefit from focal treatment, whereas metastases in lungs, lymph nodes, or liver respond |
| Tolerance |
AEs are significant and may lead to a dose reduction in 11-73% of patients and to MKI withdrawal in 7-25%. However, AEs can frequently be managed without the need for dose reduction or discontinuation of treatment. Also, the tolerance is highly variable from patient to patient and between different MKIs |
| Availability of other treatment modalities |
Availability of other drugs or possibility to include patients in international protocols of new drugs |
