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WCLC 2020: Novel Tyrosine Kinase Inhibitor Versus Chemotherapy for EGFR-Mutated NSCLC

By: Julia Fiederlein
Posted: Monday, February 1, 2021

According to Caicun Zhou, PhD, MD, of the Shanghai Pulmonary Hospital, China, and colleagues, patients with EGFR-mutated stage II to IIIA non–small cell lung cancer (NSCLC) appeared to derive a disease-free survival benefit from adjuvant icotinib compared with standard chemotherapy. The results of the multicenter phase III EVIDENCE trial were presented at the International Association for the Study of Lung Cancer 2020 World Conference on Lung Cancer Singapore (WCLC; Abstract JICC01.11), held in virtual format in January 2021.

“Recent studies have shown significant benefits of EGFR tyrosine kinase inhibitors in the adjuvant setting for patients with EGFR-mutated stage IB to IIIA resected NSCLC,” the investigators noted. “Icotinib can provide a new treatment option for [these patients].”

Patients with completely resected disease were randomly assigned in a 1:1 ratio to receive either adjuvant icotinib (n = 151) or a four-cycle chemotherapy regimen of cisplatin plus vinorelbine or pemetrexed (n = 132). Follow-up data were provided for a median of 24.9 months. The median durations of disease-free survival were 47.0 and 22.1 months with icotinib and chemotherapy, respectively (stratified hazard ratio = 0.36; P < .0001). Icotinib seemed to show consistent disease-free survival benefits across all subgroups. The 3-year disease-free survival rate was 63.9% with icotinib and 32.5% with chemotherapy.

The study remains immature for overall survival analysis; deaths were reported in 9.3% and 10.6% of patients treated with icotinib and chemotherapy, respectively. More adverse events of grade 3 or 4 were reported with chemotherapy than with icotinib (61.2% vs. 10.9%, respectively). Additionally, compared with icotinib, treatment-related serious adverse events occurred at a higher rate with chemotherapy (1.3% vs. 13.7%, respectively). Interstitial pneumonia and treatment-related death were not reported in either group.

Disclosure: For full disclosures of the study authors, visit wclc2020.iaslc.org.



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