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Randomized Adjuvant Chemotherapy of EGFR-Mutated Non-Small Cell Lung Cancer Patients with or without Icotinib Consolidation Therapy.

Feng S, Wang Y, Cai K, Wu H, Xiong G, Wang H, Zhang Z - PLoS ONE (2015)

Bottom Line: Treatment of advanced NSCLC patients with EGFR-tyrosine kinase inhibitor (EGFR-TKI) confers a significant survival benefit.DFS at 12 months was 100% for icotinib-treated patients and 88.9% for chemotherapy-only patients (p = 0. 122).At 18 months DFS for icotinib-treated vs. chemotherapy-only patients was 95.2% vs. 83.3% (p = 0. 225), respectively, and at 24 months DFS was 90.5% vs. 66.7% (p = 0. 066).

View Article: PubMed Central - PubMed

Affiliation: Department of Thoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.

ABSTRACT

Background: Epidermal growth factor receptor (EGFR) mutations occur in up to 50% of Asian patients with non-small cell lung cancer (NSCLC). Treatment of advanced NSCLC patients with EGFR-tyrosine kinase inhibitor (EGFR-TKI) confers a significant survival benefit. This study assessed the efficacy and safety of chemotherapy with or without icotinib in patients undergoing resection of stage IB to ⅢA EGFR-mutated NSCLC.

Methods: Patients with surgically resected stage IB (with high risk factors) to ⅢA EGFR-mutated NSCLC were randomly assigned (1:1) to one of two treatment plans. One group received four cycles of platinum-based doublet chemotherapy every three weeks, and the other group received platinum-based chemotherapy supplemented with consolidation therapy of orally administered icotinib (125 mg thrice daily) two weeks after chemotherapy. The icotinib treatment continued for four to eight months, or until the occurrence of disease relapse, metastasis or unacceptable icotinib or chemotherapy toxicity. The primary endpoint was disease-free survival (DFS).

Results: 41 patients were enrolled between Feb 9, 2011 and Dec 17, 2012. 21 patients were assigned to the combined chemotherapy plus icotinib treatment group, while 20 patients received chemotherapy only. DFS at 12 months was 100% for icotinib-treated patients and 88.9% for chemotherapy-only patients (p = 0. 122). At 18 months DFS for icotinib-treated vs. chemotherapy-only patients was 95.2% vs. 83.3% (p = 0. 225), respectively, and at 24 months DFS was 90.5% vs. 66.7% (p = 0. 066). The adverse chemotherapy effects predominantly presented as gastrointestinal reactions and marrow suppression, and there was no significant difference between the two treatment groups. Patients in the chemotherapy plus icotinib treatment group showed favorable tolerance to oral icotinib.

Conclusions: The results suggest that chemotherapy plus orally icotinib displayed better DFS compared with chemotherapy only, yet the difference in DFS was not significant. We would think the preliminary result here was promising, and further trials with larger sample sizes might confirm the efficiency of adjuvant TKI in selected patients.

Trial registration: ClinicalTrials.gov NCT02430974.

No MeSH data available.


Related in: MedlinePlus

Kaplan-Meier curves for disease-free survival in subgroups.Kaplan-Meier curves for disease-free survival by treatment arm are shown for patients with stage IB (A), Ⅱ (B) or ⅢA (C) NSCLC.
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pone.0140794.g003: Kaplan-Meier curves for disease-free survival in subgroups.Kaplan-Meier curves for disease-free survival by treatment arm are shown for patients with stage IB (A), Ⅱ (B) or ⅢA (C) NSCLC.

Mentions: We performed a subgroup analysis of DFS according to the pTNM stage, although this analysis included only 17 patients in the high-risk stage IB subgroup, 10 in the stageⅡsubgroup and 12 in the stage ⅢA subgroup. There was no recurrence event in the high-risk stage IB subgroup during the follow-up period (Fig 3A). The DFS rate was 4 (80.0%) vs 3 (60.0%) in the stageⅡsubgroup (p = 0. 448; Fig 3B) and 6 (85.7%) and 1 (20.0%) in the stage ⅢA subgroup (p = 0. 027; Fig 3C).


Randomized Adjuvant Chemotherapy of EGFR-Mutated Non-Small Cell Lung Cancer Patients with or without Icotinib Consolidation Therapy.

Feng S, Wang Y, Cai K, Wu H, Xiong G, Wang H, Zhang Z - PLoS ONE (2015)

Kaplan-Meier curves for disease-free survival in subgroups.Kaplan-Meier curves for disease-free survival by treatment arm are shown for patients with stage IB (A), Ⅱ (B) or ⅢA (C) NSCLC.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4608803&req=5

pone.0140794.g003: Kaplan-Meier curves for disease-free survival in subgroups.Kaplan-Meier curves for disease-free survival by treatment arm are shown for patients with stage IB (A), Ⅱ (B) or ⅢA (C) NSCLC.
Mentions: We performed a subgroup analysis of DFS according to the pTNM stage, although this analysis included only 17 patients in the high-risk stage IB subgroup, 10 in the stageⅡsubgroup and 12 in the stage ⅢA subgroup. There was no recurrence event in the high-risk stage IB subgroup during the follow-up period (Fig 3A). The DFS rate was 4 (80.0%) vs 3 (60.0%) in the stageⅡsubgroup (p = 0. 448; Fig 3B) and 6 (85.7%) and 1 (20.0%) in the stage ⅢA subgroup (p = 0. 027; Fig 3C).

Bottom Line: Treatment of advanced NSCLC patients with EGFR-tyrosine kinase inhibitor (EGFR-TKI) confers a significant survival benefit.DFS at 12 months was 100% for icotinib-treated patients and 88.9% for chemotherapy-only patients (p = 0. 122).At 18 months DFS for icotinib-treated vs. chemotherapy-only patients was 95.2% vs. 83.3% (p = 0. 225), respectively, and at 24 months DFS was 90.5% vs. 66.7% (p = 0. 066).

View Article: PubMed Central - PubMed

Affiliation: Department of Thoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.

ABSTRACT

Background: Epidermal growth factor receptor (EGFR) mutations occur in up to 50% of Asian patients with non-small cell lung cancer (NSCLC). Treatment of advanced NSCLC patients with EGFR-tyrosine kinase inhibitor (EGFR-TKI) confers a significant survival benefit. This study assessed the efficacy and safety of chemotherapy with or without icotinib in patients undergoing resection of stage IB to ⅢA EGFR-mutated NSCLC.

Methods: Patients with surgically resected stage IB (with high risk factors) to ⅢA EGFR-mutated NSCLC were randomly assigned (1:1) to one of two treatment plans. One group received four cycles of platinum-based doublet chemotherapy every three weeks, and the other group received platinum-based chemotherapy supplemented with consolidation therapy of orally administered icotinib (125 mg thrice daily) two weeks after chemotherapy. The icotinib treatment continued for four to eight months, or until the occurrence of disease relapse, metastasis or unacceptable icotinib or chemotherapy toxicity. The primary endpoint was disease-free survival (DFS).

Results: 41 patients were enrolled between Feb 9, 2011 and Dec 17, 2012. 21 patients were assigned to the combined chemotherapy plus icotinib treatment group, while 20 patients received chemotherapy only. DFS at 12 months was 100% for icotinib-treated patients and 88.9% for chemotherapy-only patients (p = 0. 122). At 18 months DFS for icotinib-treated vs. chemotherapy-only patients was 95.2% vs. 83.3% (p = 0. 225), respectively, and at 24 months DFS was 90.5% vs. 66.7% (p = 0. 066). The adverse chemotherapy effects predominantly presented as gastrointestinal reactions and marrow suppression, and there was no significant difference between the two treatment groups. Patients in the chemotherapy plus icotinib treatment group showed favorable tolerance to oral icotinib.

Conclusions: The results suggest that chemotherapy plus orally icotinib displayed better DFS compared with chemotherapy only, yet the difference in DFS was not significant. We would think the preliminary result here was promising, and further trials with larger sample sizes might confirm the efficiency of adjuvant TKI in selected patients.

Trial registration: ClinicalTrials.gov NCT02430974.

No MeSH data available.


Related in: MedlinePlus