Icotinib combined whole brain radiotherapy for patients with brain metastasis from lung adenocarcinoma harboring epidermal growth factor receptor mutation

Li, Jingrui; Zhang, Ye; Ji, Zheng

doi:10.21037/jtd.2016.05.70

Cited by 5 publications

(3 citation statements)

References 33 publications

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“…Several researches have clarified that NSCLC patients harboring EGFR exon 19 deletion or exon 21 L858R can benefit from icotinib and osimertinib. 26,27 In this study, 38.82% of MM patients bearing EGFR mutations in the 18-21 exon region, among which exon 19 deletion and L858R accounted for 62.5% of all EGFR mutations. The lung adenocarcinoma patients harboring sensitive EGFR mutations benefit from EGFR-TKI drugs.…”

Section: Discussionmentioning

confidence: 57%

The Presence of Genomic Instability in Cerebrospinal Fluid in Patients with Meningeal Metastasis

Wang¹,

Zhang²,

Chen³

et al. 2021

CMAR

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This study aimed to explore the genomic instability in cerebrospinal fluid (CSF) in patients with meningeal metastasis (MM). Material and Methods: We collected the blood and CSF samples of 15 MM patients and one brain parenchymal metastasis (BPM) patient. A panel of 543 cancer-related genes was conducted to analyze the status of genomic instability in CSF and plasma cellfree DNA (cfDNA) of all patients. Subsequently, nine patients underwent low-depth whole-genome sequencing (WGS) analysis to verify the existence of genomic instability, followed by genomic scoring by the application of aneuploidy scores. Diagnosis-specific graded prognostic assessment (DS-GPA) score was utilized to assess the clinical status of MM patients. Results: There was significant difference in gene mutation between CSF cfDNA and plasma cfDNA in MM patients. Among them, 12 MM patients developed genomic instability in their CSF cfDNA, while the remaining 3 had stable genetic profile. Besides, BPM patients showed genomic stability in his CSF and paraffin-embedded tissue sections. No genomic instability was noticed in plasma cfDNA of all patients. Sensitive mutations on EGFR, ERBB2, ALK and KRAS genes and increased gene copy numbers of MET and ERBB2 were detected in 10 MM patients with genomic instability, as well as the EGFR gene mutation in one MM case with genomic stability. Additionally, MM patients with genomic instability had lower overall survival and higher aneuploidy scores and tumor mutation burden compared with those with genomic stability. Moreover, MM patients with higher DS-GPA scores benefited from better survival. Conclusion: Genomic instability existed in the CSF cfDNA rather than plasma cfDNA of MM patients, which might be the underlying cause of the differences in MM.

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Section: Discussionmentioning

confidence: 57%

The Presence of Genomic Instability in Cerebrospinal Fluid in Patients with Meningeal Metastasis

Wang¹,

Zhang²,

Chen³

et al. 2021

CMAR

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“…EGFR inhibitors can reduce the radiation resistance of EGFR mutant tumor cells by reducing DNA repair, proliferation and anti-apoptosis, thereby promoting the curative effect of chemotherapy. [22] As the first EGFR-TKI in China, icotinib shows good anticancer activity in vitro and in vivo. [23] Shortly speaking, icotinib can bind to adenosine triphosphate binding site of EGFR, inhibit EGFR activation, block downstream signal transmission, and then inhibit tumor proliferation and migration, and induce tumor apoptosis and other biological effects.…”

Section: Discussionmentioning

confidence: 99%

A meta-analysis for the efficacy and safety of icotinib combined with radiotherapy in treating brain metastases of non-small cell lung cancer

Zhang

2023

Medicine

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Background: Currently, the therapies for brain metastases of non-small cell lung cancer (NSCLC) mainly include whole brain radiotherapy and icotinib. For exploring the efficacy and safety of radiotherapy and icotinib, a meta-analysis was performed based on a series of data. Method: A systematic search was performed on PubMed, Web of Science, Cochrane Library, China National Knowledge Infrastructure and Wanfang Database. The search time was set from the database establishment to December, 2022. All randomized controlled trials evaluating the efficacy and safety of whole brain radiotherapy alone or in combination with icotinib for whole brain metastases of NSCLC were included in our meta-analysis. Clinical outcomes and adverse reactions were analyzed using Stata17.0 software. Results: Finally, 10 clinical studies were enrolled in this meta-analysis, including 717 patients. Briefly, compared with radiotherapy alone, icotinib combined with radiotherapy increased response rate [relative ratio (RR) = 1.240; 95% confidence interval (CI) (1.141, 1.348); P < .001] and disease control rate (RR = 1.240, 95% CI [1.141,1.348], P < .001). Besides, according to the outcomes of adverse reaction assessment exhibited, there were no significant differences between the 2 group patients in the incidence of rash (RR = 1.536, 95% CI [0.694, 3.402], P = .290), adverse reaction in gastrointestinal tract (RR = 1.060, 95% CI [0.792, 1.419], P = 1.419), hepatic injury (RR = 1.541, 95% CI [0.798,2.975], P = .198) and leukopenia (RR = 1.182, 95% CI [0.787, 1.777], P = .421). However, the patients receiving combination treatment showed much longer progression free survival than those receiving radiotherapy alone (standardized mean difference = 1.559; 95% CI [0.699, 2.419]; P < .001). Conclusion: Icotinib combined with radiotherapy can significantly short-term and long-term efficacy of NSCLC patients with brain metastases but not increase adverse reactions.

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“…A study by Li et al et al 2016) aimed to explore the e cacy and safety of icotinib combined with WBRT in treatment of EGFR-mutant lung adenocarcinoma with brain metastatic (BMS). A total of 43 patients were included, all of whom received standard WBRT (3Gy per day, 5 times per week, 30Gy in total) with synchronous icotinib.…”

Section: Icotinib Combined With Radiotherapymentioning

confidence: 99%

Status and progress of Icotinib in treatment of EGFR-mutant non-small cell lung carcinoma

Huang¹,

Zhou

2022

Preprint

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Lung cancer has a high incidence and mortality worldwide. Among them, non-small cell lung cancer (NSCLC) accounts for the majority. In terms of treatment, targeted therapy is a more effective option for NSCLC patients with genetic mutations when compared with chemotherapy. Currently, there are a number of targeted drugs targeting different mutations in NSCLC on the market, among which, icotinib (Conmona®) is an oral small molecule epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI). It’s approved as first-line treatment for locally advanced or metastatic NSCLC patients with EGFR-mutant, for monotherapy to treat locally advanced or metastatic non-small cell lung cancer (NSCLC) after the failure of at least one prior chemotherapy regimen (primarily platinum-based combination chemotherapy) and approved as postoperative adjuvent therapy for stage Ⅱ-ⅢA NSCLC with EGFR-mutant in China. What’s more, there are many other usages and further clinical trials are underway. Here, we review the status and progress of icotinib in the treatment of EGFR-mutant NSCLC.

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Icotinib combined whole brain radiotherapy for patients with brain metastasis from lung adenocarcinoma harboring epidermal growth factor receptor mutation

Cited by 5 publications

References 33 publications

The Presence of Genomic Instability in Cerebrospinal Fluid in Patients with Meningeal Metastasis

The Presence of Genomic Instability in Cerebrospinal Fluid in Patients with Meningeal Metastasis

A meta-analysis for the efficacy and safety of icotinib combined with radiotherapy in treating brain metastases of non-small cell lung cancer

Status and progress of Icotinib in treatment of EGFR-mutant non-small cell lung carcinoma

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