Sequential Chemotherapy and Icotinib As First-line Treatment for Advanced Epidermal Growth Factor Receptor-mutated Non-small Cell Lung Cancer

Overview

Journal World J Clin Cases

Publisher Baishideng Publishing Group

Specialty General Medicine

Date 2022 Aug 11

PMID 35949840

Authors

Sheng-Jie Sun

Jin-Di Han

Wei Liu

Zhi-Yong Wu

Xiao Zhao

Xiang Yan

Shun-Chang Jiao

Jian Fang

Affiliations

Soon will be listed here.

Abstract

Background: Icotinib could have potential effect and tolerability when used sequentially with chemotherapy for advanced epidermal growth factor receptor ()-mutated non-small cell lung cancer (NSCLC).

Aim: To evaluate the efficacy and safety of chemotherapy followed by icotinib maintenance therapy as first-line treatment for advanced -mutated NSCLC.

Methods: This multicenter, open-label, pilot randomized controlled trial enrolled 68 -mutated stage IIIB/IV NSCLC patients randomized 2:3 to the icotinib alone and chemotherapy + icotinib groups.

Results: The median progression-free survival in the icotinib alone and chemotherapy + icotinib groups was 8.0 mo (95%CI: 3.84-11.63) and 13.4 mo (95%CI: 10.18-16.33), respectively ( = 0.0249). No significant differences were found in the curative effect when considering different cycles of chemotherapy or chemotherapy regimen (all > 0.05).

Conclusion: A sequential combination of chemotherapy and EGFR-tyrosine kinase inhibitor is feasible for stage IV -mutated NSCLC patients.

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References

Yang J, Gadgeel S, Sequist L, Wu C, Papadimitrakopoulou V, Su W . Pembrolizumab in Combination With Erlotinib or Gefitinib as First-Line Therapy for Advanced NSCLC With Sensitizing EGFR Mutation. J Thorac Oncol. 2018; 14(3):553-559. DOI: 10.1016/j.jtho.2018.11.028. View

Nan X, Xie C, Yu X, Liu J . EGFR TKI as first-line treatment for patients with advanced EGFR mutation-positive non-small-cell lung cancer. Oncotarget. 2017; 8(43):75712-75726. PMC: 5650459. DOI: 10.18632/oncotarget.20095. View

Horinouchi H . To combine or not to combine: anti-vascular endothelial growth factor therapies in EGFR mutation positive non-small cell lung cancer. Ann Transl Med. 2020; 8(8):554. PMC: 7214908. DOI: 10.21037/atm.2020.01.66. View

Singer J, Irmisch A, Ruscheweyh H, Singer F, Toussaint N, Levesque M . Bioinformatics for precision oncology. Brief Bioinform. 2017; 20(3):778-788. PMC: 6585151. DOI: 10.1093/bib/bbx143. View

Jin R, Zhao J, Xia L, Li Q, Li W, Peng L . Application of immune checkpoint inhibitors in EGFR-mutant non-small-cell lung cancer: from bed to bench. Ther Adv Med Oncol. 2020; 12:1758835920930333. PMC: 7285948. DOI: 10.1177/1758835920930333. View

Mohsenzadegan M, Peng R, Roudi R . Dendritic cell/cytokine-induced killer cell-based immunotherapy in lung cancer: What we know and future landscape. J Cell Physiol. 2019; 235(1):74-86. DOI: 10.1002/jcp.28977. View

Yang J, Srimuninnimit V, Ahn M, Lin C, Kim S, Tsai C . First-Line Pemetrexed plus Cisplatin followed by Gefitinib Maintenance Therapy versus Gefitinib Monotherapy in East Asian Never-Smoker Patients with Locally Advanced or Metastatic Nonsquamous Non-Small Cell Lung Cancer: Final Overall Survival.... J Thorac Oncol. 2016; 11(3):370-9. DOI: 10.1016/j.jtho.2015.11.008. View

Roviello G, Zanotti L, Cappelletti M, Gobbi A, Dester M, Paganini G . Are EGFR tyrosine kinase inhibitors effective in elderly patients with EGFR-mutated non-small cell lung cancer?. Clin Exp Med. 2017; 18(1):15-20. DOI: 10.1007/s10238-017-0460-7. View

Choi Y, Lee D, Choi C, Lee J, Lee S, Ahn J . Randomized phase II study of paclitaxel/carboplatin intercalated with gefitinib compared to paclitaxel/carboplatin alone for chemotherapy-naïve non-small cell lung cancer in a clinically selected population excluding patients with non-smoking.... BMC Cancer. 2015; 15:763. PMC: 4619194. DOI: 10.1186/s12885-015-1714-y. View

10.

Sugawara S, Oizumi S, Minato K, Harada T, Inoue A, Fujita Y . Randomized phase II study of concurrent versus sequential alternating gefitinib and chemotherapy in previously untreated non-small cell lung cancer with sensitive EGFR mutations: NEJ005/TCOG0902. Ann Oncol. 2015; 26(5):888-894. DOI: 10.1093/annonc/mdv063. View

11.

Patil P, Shepherd F, Johnson D . A Career in Lung Cancer: Pushing Beyond Chemotherapy. Am Soc Clin Oncol Educ Book. 2019; 39:583-589. DOI: 10.1200/EDBK_239397. View

12.

Giovannetti E, Lemos C, Tekle C, Smid K, Nannizzi S, Rodriguez J . Molecular mechanisms underlying the synergistic interaction of erlotinib, an epidermal growth factor receptor tyrosine kinase inhibitor, with the multitargeted antifolate pemetrexed in non-small-cell lung cancer cells. Mol Pharmacol. 2008; 73(4):1290-300. DOI: 10.1124/mol.107.042382. View

13.

Nishino M, Jackman D, Hatabu H, Yeap B, Cioffredi L, Yap J . New Response Evaluation Criteria in Solid Tumors (RECIST) guidelines for advanced non-small cell lung cancer: comparison with original RECIST and impact on assessment of tumor response to targeted therapy. AJR Am J Roentgenol. 2010; 195(3):W221-8. PMC: 3130298. DOI: 10.2214/AJR.09.3928. View

14.

Petrelli F, Ghidini A, Luciani A . Topotecan or other agents as second-line therapy for relapsed small-cell lung cancer: A meta-analysis of randomized studies. Mol Clin Oncol. 2021; 15(4):218. PMC: 8408676. DOI: 10.3892/mco.2021.2383. View

15.

Zheng Y, Fang W, Deng J, Zhao P, Xu N, Zhou J . Sequential treatment of icotinib after first-line pemetrexed in advanced lung adenocarcinoma with unknown EGFR gene status. J Thorac Dis. 2014; 6(7):958-64. PMC: 4120162. DOI: 10.3978/j.issn.2072-1439.2014.07.18. View

16.

Zhang L, Qi Y, Xing K, Qian S, Zhang P, Wu X . A novel strategy of EGFR‑TKI combined chemotherapy in the treatment of human lung cancer with EGFR‑sensitive mutation. Oncol Rep. 2018; 40(2):1046-1054. DOI: 10.3892/or.2018.6499. View

17.

Yang J, Kang J, Mok T, Ahn M, Srimuninnimit V, Lin C . First-line pemetrexed plus cisplatin followed by gefitinib maintenance therapy versus gefitinib monotherapy in East Asian patients with locally advanced or metastatic non-squamous non-small cell lung cancer: a randomised, phase 3 trial. Eur J Cancer. 2014; 50(13):2219-30. DOI: 10.1016/j.ejca.2014.05.011. View

18.

Cabanero M, Sangha R, Sheffield B, Sukhai M, Pakkal M, Kamel-Reid S . Management of mutated non-small-cell lung cancer: practical implications from a clinical and pathology perspective. Curr Oncol. 2017; 24(2):111-119. PMC: 5407862. DOI: 10.3747/co.24.3524. View

19.

Yan X, Wang H, Li P, Zhang G, Zhang M, Yang J . Efficacy of first-line treatment with epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) alone or in combination with chemotherapy for advanced non-small cell lung cancer (NSCLC) with low-abundance mutation. Lung Cancer. 2019; 128:6-12. DOI: 10.1016/j.lungcan.2018.12.007. View

20.

Feng X, Zhang Y, Li T, Li Y . Sequentially administrated of pemetrexed with icotinib/erlotinib in lung adenocarcinoma cell lines . Oncotarget. 2018; 8(69):114292-114299. PMC: 5768404. DOI: 10.18632/oncotarget.23224. View