Everolimus, as an mTOR inhibitor, has shown significant efficacy in various indications, but standardized discontinuation is necessary to avoid adverse reactions. The following provides a detailed explanation from two aspects: treatment effectiveness and precautions for stopping medication, to help patients take medication safely.

1. Therapeutic effect

(1) Advanced renal cell carcinoma: Combination with exemestane can prolong progression free survival with an objective response rate of 12%.

(2) Breast cancer: the median progression free survival time of patients with hormone receptor positive/HER2 negative advanced breast cancer is about 7.8 months.

(3) Neuroendocrine tumors: The median progression free survival for pancreatic origin patients is up to 11 months, while for non pancreatic origin patients it is approximately 13 months.

(4) Organ transplantation: Combined with cyclosporine, it can significantly reduce the incidence of acute rejection to about 15-20%.

2. Precautions for discontinuation of medication

(1) The principle of gradual reduction

Transplant patients need to strictly follow medical advice and gradually reduce dosage. Sudden discontinuation of medication may cause acute rejection reactions, and renal function and immune indicators need to be monitored.

(2) Indications for discontinuation of medication in cancer patients

When grade 4 non hematological toxicity, grade 3 interstitial lung disease, or intolerable grade 2 toxicity occurs, the medication should be permanently discontinued and symptomatic supportive treatment should be received.

(3) Monitoring requirements

Continuous monitoring of blood glucose and lipid levels for 8 weeks after discontinuation of medication; Transplant patients need lifelong follow-up for signs of rejection reactions, such as fever and pain at the transplant site.

(4) Handling of special populations

Patients with liver dysfunction need to extend the monitoring period after discontinuing medication; Women of childbearing age should continue contraception for 8 weeks after discontinuing medication to avoid the effects of drug residues.