First-line icotinib versus cisplatin/pemetrexed plus pemetrexed maintenance therapy for patients with advancedEGFR mutation-positive lung adenocarcinoma (CONVINCE): a phase 3, open-label, randomized study

Shi, Yuankai; Wang, L.; Han, Baohui; Li, W.; Yu, Ping; Liu, Y. P.; Ding, Cuimin; Song, Xuejiao; Y., Z.; Ren, Xue; Feng, J.; Zhang, H. L.; Chen, G. Y.; Han, Xiaohong; Wu, Ning; Yao, Chia-Yu; Song, Yong; Zhang, S. C.; Song, Wei; Liu, X. Q.; Zhao, Sha; Lin, Yongjuan; Ye, X. Q.; Li, Kai; Shu, Yongqian; Ding, Lieming; Tan, Fenlai; Sun, Yan

doi:10.1093/annonc/mdx359

Cited by 237 publications

(222 citation statements)

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“…The prognosis of patients with advanced non-small cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutations has dramatically changed in the last years as a result of the incorporation of targeted therapies with tyrosine kinase inhibitors (TKIs) into the first line, resulting in much better tolerated treatments than standard chemotherapy and improved response rates and progression-free survival (PFS) [3,4,5,6,7,8,9]. Although overall survival (OS) has clearly increased when compared with historical data from the pre-targeted therapy era, randomized trials of TKIs versus chemotherapy have not shown an OS advantage for EGFR-mutant patients, mainly due to the treatment crossover at progression, with the exception of the subset of patients with exon 19 deletion treated with the TKI afatinib [10].…”

Section: Introductionmentioning

confidence: 99%

Neutrophil to Lymphocyte Ratio as a Prognostic Factor in European Patients with Epidermal Growth Factor Receptor-Mutant Non-Small Cell Lung Cancer Treated with Tyrosine Kinase Inhibitors

et al. 2018

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Background: A high neutrophil to lymphocyte ratio (NLR) has been associated with adverse outcomes in non-small cell lung cancer (NSCLC). However, information on epidermal growth factor receptor (EGFR)-mutant advanced NSCLC is scarce, and most of the studies published have been conducted in Asian populations. We aimed to assess the influence of pretreatment NLR on progression-free survival (PFS) and overall survival (OS) in Western European patients treated with EGFR tyrosine kinase inhibitors (TKIs). Methods: A retrospective evaluation of 41 patients with EGFR-mutant advanced NSCLC treated with EGFR TKIs between June 2010 and May 2016 was carried out. The association between several prognostic factors including pretreatment NLR and survival was analyzed. Results: Median PFS and OS were 10.58 and 20.84 months, respectively. OS for patients with a high NLR was 7.4 months, compared to 24.6 months for patients with a low NLR (p = 0.0122). In multivariate analysis, poor performance status (ECOG PS ≥ 2) and presence of ≥ 3 metastatic locations were identified as significant independent prognostic factors for worse PFS. For OS, unfavorable prognostic factors were a high NLR and central nervous system metastasis at diagnosis. Conclusion: Pretreatment NLR is an independent prognostic factor for OS in Western European patients with EGFR-mutant NSCLC treated with EGFR TKIs.

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Section: Introductionmentioning

confidence: 99%

Neutrophil to Lymphocyte Ratio as a Prognostic Factor in European Patients with Epidermal Growth Factor Receptor-Mutant Non-Small Cell Lung Cancer Treated with Tyrosine Kinase Inhibitors

et al. 2018

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“…Epidermal growth factor receptor ( EGFR ) gene mutations occur in approximately 50% of Asian non‐small cell lung cancer (NSCLC) patients, particularly in never‐smokers and patients with adenocarcinoma . First‐line treatment with reversible first‐generation EGFR tyrosine kinase inhibitors (TKIs), such as gefitinib, erlotinib, and icotinib, and second‐generation EGFR TKIs (afatinib) have been shown to improve progression‐free survival (PFS) in NSCLC patients with EGFR ‐sensitive mutations compared with chemotherapy . However, despite the good initial responses of these first‐ and second‐generation EGFR TKIs, most patients develop acquired resistance.…”

Section: Introductionmentioning

confidence: 99%

“…2 First-line treatment with 594 reversible first-generation EGFR tyrosine kinase inhibitors (TKIs), such as gefitinib, erlotinib, and icotinib, and second-generation EGFR TKIs (afatinib) have been shown to improve progression-free survival (PFS) in NSCLC patients with EGFR-sensitive mutations compared with chemotherapy. [3][4][5][6][7][8] However, despite the good initial responses of these firstand second-generation EGFR TKIs, most patients develop acquired resistance. Moreover, there has been no evidence that patients benefit from the sequential use of different first-generation EGFR TKIs.…”

Section: Introductionmentioning

confidence: 99%

Abivertinib in patients with T790M‐positive advanced NSCLC and its subsequent treatment with osimertinib

et al. 2020

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Background Abivertinib is a novel oral, third generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) that overcomes T790M‐induced resistance in non‐small cell lung cancer (NSCLC) patients. Here, we report the results of a complete and detailed clinical data of patients treated with abivertinib at our hospital in a phase I dose escalation/expansion study of abivertinib. Methods NSCLC patients with the EGFR T790M mutation were orally administered abivertinib (150–300 mg) twice daily for cycles of 28 continuous days and tumor response was assessed. Further data regarding subsequent treatment protocols and survival were collected. Results A total of 28 NSCLC patients were included. Of the 24 assessable patients, 12 (50%) achieved a partial response (PR), and six (25%) achieved stable disease (SD). Median progression‐free survival (PFS) was 5.9 months (95% confidence interval (CI): 3.259–8.541) and median overall survival (OS) was 17.9 months (95% CI: 11.36–24.5). For salvage therapy in 15 (53.6%) patients after abivertinib, the median PFS following osimertinib treatment was 12 months. The median total treatment duration for the two third‐generation EGFR TKIs was 15.9 months (95% CI: 12.5–19.3). The most frequent abivertinib‐associated adverse effects were elevated hepatic transaminases (10/28, 35.7%) and diarrhea (10/28, 35.7%). Conclusions Abivertinib is a unique novel third‐generation EGFR TKI with good tolerance and efficacy in EGFR T790M(+) NSCLC patients. For patients with progressive disease after treatment with abivertinib, osimertinib could be an option for subsequent therapy but further studies are required. Key points Abivertinib is a novel third‐generation EGFR TKI targeting the EGFR T790M mutation Abivertinib is well tolerated and efficacious in T790M‐positive patients Abivertinib has a unique structure, efficacy, and resistance mechanism compared with osimertinib Osimertinib treatment after AC0010 showed a good response

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“…Despite high tumor response rates with first‐line EGFR‐TKIs, the majority of patients acquire resistance to first‐generation EGFR‐TKIs within a year . It is estimated that 50–60% of patients develop T790M mutations .…”

Section: Introductionmentioning

confidence: 99%

“…Despite high tumor response rates with first-line EGFR-TKIs, the majority of patients acquire resistance to firstgeneration EGFR-TKIs within a year. [5][6][7] It is estimated that 50-60% of patients develop T790M mutations. 8 For T790M positive patients, osimertinib is more effective than chemotherapy; 9 however, cytotoxic chemotherapy is still the best choice for T790M negative patients.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of pemetrexed and carboplatin with or without bevacizumab in lung adenocarcinoma patients with EGFR non‐T790M mutations after progression on first‐line EGFR‐tyrosine kinase inhibitors

et al. 2018

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BackgroundThe purpose of this study was to compare the effects of pemetrexed and carboplatin plus bevacizumab (PC + B) versus pemetrexed and carboplatin (PC) in lung adenocarcinoma patients with EGFR non‐T790M mutations after progression on first‐line EGFR‐tyrosine kinase inhibitors (TKIs).MethodsPatients with EGFR‐positive lung adenocarcinoma who had received second‐line PC with or without bevacizumab harboring EGFR non‐T790M mutations after progression on first‐line EGFR‐TKIs between April 2015 and 2017 at Tianjin Medical University Cancer Institute and Hospital were enrolled in the study. The primary endpoint was progression‐free survival and secondary endpoints were overall survival, objective response rate, disease control rate, and safety.ResultsA total of 85 patients were eligible for the study: 55 and 30 cases were enrolled in the PC and PC + B groups, respectively. The median progression‐free survival was prolonged with PC + B compared to PC (median 8.2 vs. 5.1 months; P = 0.037). The objective response rate was improved with PC + B compared to PC (46.7% vs. 25.5%; P = 0.047) and overall survival prolonged with PC + B compared to PC (median 26.3 vs. 19.2 months; P = 0.012). Safety was similar to previous studies of bevacizumab in non‐small cell lung cancer: one patient experienced grade 3 hypertension and proteinuria but did not require the discontinuation of therapy.ConclusionThe addition of bevacizumab to PC was superior to PC alone as second‐line therapy in patients with advanced non‐T90M EGFR‐positive lung adenocarcinoma. However, this result needs to be confirmed by prospective clinical trials.

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First-line icotinib versus cisplatin/pemetrexed plus pemetrexed maintenance therapy for patients with advancedEGFR mutation-positive lung adenocarcinoma (CONVINCE): a phase 3, open-label, randomized study

Abstract: First-line icotinib significantly improves PFS of advanced lung adenocarcinoma patients with EGFR mutation with a tolerable and manageable safety profile. Icotinib should be considered as a first-line treatment for this patient population.

Cited by 237 publications

References 19 publications

Neutrophil to Lymphocyte Ratio as a Prognostic Factor in European Patients with Epidermal Growth Factor Receptor-Mutant Non-Small Cell Lung Cancer Treated with Tyrosine Kinase Inhibitors

Neutrophil to Lymphocyte Ratio as a Prognostic Factor in European Patients with Epidermal Growth Factor Receptor-Mutant Non-Small Cell Lung Cancer Treated with Tyrosine Kinase Inhibitors

Abivertinib in patients with T790M‐positive advanced NSCLC and its subsequent treatment with osimertinib

Efficacy of pemetrexed and carboplatin with or without bevacizumab in lung adenocarcinoma patients with EGFR non‐T790M mutations after progression on first‐line EGFR‐tyrosine kinase inhibitors

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