Icotinib Dosage May Affect Outcomes in Patients With NSCLC and Genetic Mutation
Posted: Thursday, July 16, 2020
Shucai Zhang, MD, of Capital Medical University, Beijing, China, and colleagues found that compared with routine doses of the EGFR tyrosine kinase inhibitor icotinib, high doses appeared to improve response and survival outcomes in patients with non–small cell lung cancer (NSCLC) who harbored the exon 21-L858R mutation. Findings from the phase II INCREASE study indicated that high-dose icotinib may be a suitable treatment option for this patient population. The report was published in Clinical Cancer Research.
The research team enrolled 253 patients with EGFR-positive NSCLC, who had not received any previous treatment. Tumor tissue had to be positive for exon 19 deletion or exon 21-L858R mutation. Patients with the L858R mutation were randomly assigned to receive routine-dose (125 mg) icotinib or high-dose (250 mg) icotinib. Those with the exon 19 deletion received routine-dose icotinib until disease progression or death.
The median progression-free survival was similar between patients with the L858R mutation who received high-dose icotinib (12.9 months) and those with the exon 19 deletion who received routine-dose icotinib (12.5 months). Among patients with the L858R mutation, those who received the high-dose treatment achieved a significantly longer median progression-free survival than those treated with the routine dose (12.9 vs. 9.2 months). Among patients who received routine-dose treatment, those with the exon 19 deletion achieved a longer median progression-free survival than those with the L858R mutation (12.5 vs. 9.2 months), although these results were nonstatistically significant.
Patients with the L858R mutation in the high-dose treatment group also achieved a higher objective response rate than a similar patient population treated with the routine dose (73% vs. 48%). Among those who received the routine-dose icotinib, patients with the exon 19 deletion achieved a higher objective response rate than those with L858R mutation (75% vs. 48%). The rate of treatment-related toxicities was similar among all patient groups.
Disclosure: For full disclosures of the study authors, visit clincancerres.org.
