Table 3.
Summary of regulatory recommendations concerning the use of TKIs prior to surgery.
| TKI | Half-Life (h) | Monitoring Recommendations a |
|---|---|---|
| Apatinib | 7.8 | Treatment should be stopped at least 30 days prior to scheduled surgery |
| Anlotinib | 116 | Treatment should be stopped at least 4 weeks prior to scheduled surgery |
| Pazopanib | 31 | Treatment should be stopped at least 7 days prior to scheduled surgery |
| Regorafenib | 28 (parent); 25–51 (metabolite) | Treatment should be stopped at least 2 weeks prior to scheduled surgery |
| Sorafenibb | 25–48 | Interruption is recommended in patients undergoing major surgical procedures |
| Sunitinibb | 40–60 (parent); 80–110 (metabolite) | Temporary interruption is recommended for precautionary reasons in patients undergoing major surgical procedures |
| Cabozantinib | 55 | Treatment should be stopped at least 28 days prior to scheduled surgery |
| Axitinib | 2.5–6.1 | Treatment should be stopped at least 24 h prior to scheduled surgery |
a
According to the latest labels for detailed recommendations on dose modifications before elective surgery.
b
Use with caution in patients at risk of gastrointestinal perforation or fistula, especially after gastrointestinal surgeries. TKI, tyrosine kinase inhibitor.