Icotinib vs. Chemotherapy in EGFR-Positive Lung Adenocarcinoma
Icotinib was given as a first-line treatment to patients with stage IIIB/IV non–small cell lung cancer (NSCLC) with the epidermal growth factor receptor (EGFR) mutation in the phase III CONVINCE trial of nearly 300 patients. It improved progression-free survival and led to fewer adverse events than did cisplatin/pemetrexed plus pemetrexed maintenance therapy. Yuankai Shi, MD, of the Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, and colleagues believe icotinib may be considered a first-line treatment in this patient group. Their study findings were published in the Annals of Oncology.
The EGFR inhibitor icotinib previously had been shown not to be inferior to gefitinib in treating NSCLC in second- and later-line treatment of nonselected patients. In the CONVINCE trial, progression-free survival was 11.2 months for the icotinib group and 7.9 months for the chemotherapy group. However, no difference in overall survival was reported between the two groups studied.
The most common adverse events for icotinib were rash (14.8%) and diarrhea (7.4%) and for chemotherapy, nausea (45.9%), vomiting (29.2%), and neutropenia (10.9%). The investigators reported the adverse events and treatment-related adverse events “were significantly fewer” in the icotinib group than in the chemotherapy group.