Survival benefit and toxicity profile of adjuvant icotinib for patients with EGFR mutation-positive non-small cell lung carcinoma: a retrospective study

Abstract

Background: Adjuvant epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are increasing considered for the tailored management of resectable non-small cell lung cancer (NSCLC). This study aimed to analyze the survival and toxicity profile of patients with EGFR mutation-positive NSCLC treated with adjuvant icotinib.Methods: This was a single-center retrospective study of patients with EGFR mutation-positive NSCLC who underwent R0 (microscopically margin-negative) resection and received adjuvant icotinib between November 2011 and December 2017. The outcomes included 2-year disease-free survival (DFS) rate, 3-year overall survival (OS) rates, DFS, OS, and adverse events (AEs).Results: A total of 86 patients receiving adjuvant icotinib were included. Their mean age was 59.7± 10.0 years, and 26 (30.2%) patients were male. The 2-year DFS rate was 86.7%, and the 3-year OS rate was 95.3% with adjuvant icotinib. DFS (P=0.044) and OS (P=0.003) are better in stage I/II disease than in stage III disease. There seems no differences in DFS and OS between patients with low or high preoperative CEA levels (cutoff of 5 ng/mL), patients with exon 19 or 21 EGFR mutation or patients with or without smoking history. The most common AEs with adjuvant icotinib were rash (83.7%) and diarrhea (19.8%). One (1.2%) patient-reported grade ≥3 AEs. No treatment-related death occurred.Conclusions: For patients with EGFR mutation-positive NSCLC, adjuvant icotinib might be associated with a promising survival benefit, with an acceptable toxicity profile.

EGFR-TKIs - induced cardiotoxicity in NSCLC: incidence, evaluation, and monitoring

“…Icotinib is a first-generation EGFR-TKIs approved by the National Medical Products Administration of China (NMPA) and is currently only available in China for the treatment of EGFR 19-deletion or L858R-mutated NSCLC, with a similar molecular structure to two first-generation EGFR-TKIs (GEF and erlotinib) ( 21 ). Compared with GEF, icotinib has similar efficacy but a better safety profile ( 22 ). Although there are increasing literature reports of cardiotoxicity caused by GEF, icotinib, which is similar in molecular structure, has not been described in the drug label or in the literature.…”