Use of Icotinib After Adjuvant Chemotherapy in EGFR-Mutated NSCLC

By: Joshua D. Madera, MD
Posted: Friday, July 12, 2024

For patients with stage II to IIIA, EGFR-mutated, non–small cell lung cancer (NSCLC), the use of adjuvant icotinib as a therapeutic strategy may improve clinical outcomes, according to a phase III trial (ICTAN, GASTO1002) presented at the 2024 American Society of Clinical Oncology (ASCO) Annual Meeting (Abstract 8004). Additional investigative efforts to determine the optimal duration of treatment with this first-generation EGFR tyrosine kinase inhibitor are warranted, suggested Si-Yu Wang, MD, of Sun Yat-sen University Cancer Center, Guangzhou, China, and colleagues.

From 2014 to 2021, a total of 251 patients with completely resected, EGFR-mutated NSCLC were recruited for the study. All patients were previously treated with platinum-based adjuvant chemotherapy. Patients were randomly assigned to receive treatment with icotinib for either 6 (n = 84) or 12 months (n = 84) or observation alone (n = 83).

The study authors reported a significant improvement in disease-free survival (hazard ratio (HR) = 0.41) and overall survival (HR = 0.56) with icotinib for 6 months compared with observation alone. Similarly, patients who received icotinib for 12 months demonstrated significantly improved disease-free survival (HR = 0.40) and overall survival (HR = 0.55) compared with patients who underwent observation alone. However, no significant differences in clinical outcomes were observed between patients treated with icotinib for 6 or 12 months. The measured median disease-free survival was 63.2 months, 61.8 months, and 23.7 months for patients treated with 6 months of icotinib, 12 months of icotinib, and observation alone, respectively. In terms of toxicity, treatment-related adverse events were experienced by 5.9% of patients receiving 6 months of icotinib, 8.3% of patients receiving 12 months of icotinib, and 2.4% of patients undergoing observation.

Disclosures: For full disclosures of the study authors, visit coi.asco.org.

2024 ASCO Annual Meeting