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Icotinib is as efficacious as gefitinib for brain metastasis of EGFR mutated non-small-cell lung cancer
Jun Jia
Dongguan People`s Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0003-1721-2723
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Cancer.
Background: The prognosis of non-small-cell lung cancer (NSCLC) with brain metastases is very poor. Currently, therapeutic methods for this patient population include whole-brain radiation therapy (WBRT), surgery, radiosurgery and systemic treatment. Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) could be effective on cerebral metastases of mutated NSCLC. However, which EGFR-TKIs is more appropriate is still unknown.
Methods: We conducted a retrospective analysis of advanced NSCLC patients with brain metastases for EGFR targeted therapy from November 2013 to April 2018 at Dongguan People’s Hospital, Southern Medical University, China. A total of 43 patients were recruit in this study. Among them, 21 cases received icotinib (125 mg, thrice a day) and 22 cases received gefitinib (250 mg, once a day) until disease progression or unacceptable toxicity. The primary end point of this study was intracranial PFS (iPFS). The relationships between therapeutic arms and patients characteristics were performed using Pearson’s chi-square test or Fisher’s exact test. The differences in PFS among the two arms were analyzed using Kaplan-Meier curves and log rank tests.
Results: There was no significant difference of intracranial ORR (66.6% versus 59.1%, P =0.62) and DCR (85.7% versus 81.8%, P =0.73) between the two arms. The median intracranial PFS (iPFS) for icotinib and gefitinib arms were 8.4 months (95% CI, 5.4 to 11.3 months) and 10.6 months (95% CI, 6.3 to 14.8 months), respectively ( P =0.17). Adverse events of the two study arms were generally mild. None of the patients experienced dose reduction of EGFR-TKIs.
Conclusions: Our study showed that icotinib and gefitinib had similar efficacy for brain metastasis of EGFR mutated NSCLC. Large randomized studies are suggested to further illuminate the effect of these two EGFR-TKIs on cerebral lesions of NSCLC.
Keywords
Brain metastasis, EGFR mutation, Targeted Therapy, Non-small-cell lung cancer (NSCLC)
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CURRENT STATUS: Published
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On 30 Jan, 2020
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On 14 Jan, 2020
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On 13 Jan, 2020
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On 12 Jan, 2020
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Editorial decision: Minor revision
On 08 Jan, 2020
Reviewers invited
Invitations sent on 03 Jan, 2020
Reviewer #1 agreed
On 03 Jan, 2020
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Received 03 Jan, 2020
Editor assigned
On 30 Dec, 2019
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Reviewer #2 agreed
On 20 Nov, 2019
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Reviewer #1 agreed
On 19 Nov, 2019
Submission checks complete
On 15 Nov, 2019
Editor invited
On 15 Nov, 2019
Editor assigned
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Editorial decision: Major revision
On 22 Oct, 2019
Review #3 received
Received 15 Sep, 2019
Review #4 received
Received 15 Sep, 2019
Review #1 received
Received 04 Sep, 2019
Review #2 received
Received 04 Sep, 2019
Reviewer #4 agreed
On 25 Aug, 2019
Reviewer #2 agreed
On 21 Aug, 2019
Reviewer #3 agreed
On 21 Aug, 2019
Editor assigned
On 20 Aug, 2019
Reviewers invited
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Reviewer #1 agreed
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This preprint is under consideration at BMC Cancer. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Icotinib is as efficacious as gefitinib for brain metastasis of EGFR mutated non-small-cell lung cancer
Jun Jia
Dongguan People`s Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0003-1721-2723
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 4
Posted 16 Jan, 2020
Published
On 30 Jan, 2020
No community comments so far
Submission checks complete
On 14 Jan, 2020
Editorial decision: Accept
On 14 Jan, 2020
Editor assigned
On 13 Jan, 2020
Editor invited
On 12 Jan, 2020
No comments provided
Editorial decision: Minor revision
On 08 Jan, 2020
Reviewers invited
Invitations sent on 03 Jan, 2020
Reviewer #1 agreed
On 03 Jan, 2020
Review #1 received
Received 03 Jan, 2020
Editor assigned
On 30 Dec, 2019
Submission checks complete
On 29 Dec, 2019
Editor invited
On 29 Dec, 2019
No comments provided
Editorial decision: Major revision
On 05 Dec, 2019
Review #2 received
Received 04 Dec, 2019
Review #1 received
Received 25 Nov, 2019
Reviewer #2 agreed
On 20 Nov, 2019
Reviewers invited
Invitations sent on 19 Nov, 2019
Reviewer #1 agreed
On 19 Nov, 2019
Submission checks complete
On 15 Nov, 2019
Editor invited
On 15 Nov, 2019
Editor assigned
On 15 Nov, 2019
No comments provided
Editorial decision: Major revision
On 22 Oct, 2019
Review #3 received
Received 15 Sep, 2019
Review #4 received
Received 15 Sep, 2019
Review #1 received
Received 04 Sep, 2019
Review #2 received
Received 04 Sep, 2019
Reviewer #4 agreed
On 25 Aug, 2019
Reviewer #2 agreed
On 21 Aug, 2019
Reviewer #3 agreed
On 21 Aug, 2019
Editor assigned
On 20 Aug, 2019
Reviewers invited
Invitations sent on 20 Aug, 2019
Reviewer #1 agreed
On 20 Aug, 2019
Editor invited
On 20 Aug, 2019
Submission checks complete
On 19 Aug, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Cancer.
Background: The prognosis of non-small-cell lung cancer (NSCLC) with brain metastases is very poor. Currently, therapeutic methods for this patient population include whole-brain radiation therapy (WBRT), surgery, radiosurgery and systemic treatment. Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) could be effective on cerebral metastases of mutated NSCLC. However, which EGFR-TKIs is more appropriate is still unknown.
Methods: We conducted a retrospective analysis of advanced NSCLC patients with brain metastases for EGFR targeted therapy from November 2013 to April 2018 at Dongguan People’s Hospital, Southern Medical University, China. A total of 43 patients were recruit in this study. Among them, 21 cases received icotinib (125 mg, thrice a day) and 22 cases received gefitinib (250 mg, once a day) until disease progression or unacceptable toxicity. The primary end point of this study was intracranial PFS (iPFS). The relationships between therapeutic arms and patients characteristics were performed using Pearson’s chi-square test or Fisher’s exact test. The differences in PFS among the two arms were analyzed using Kaplan-Meier curves and log rank tests.
Results: There was no significant difference of intracranial ORR (66.6% versus 59.1%, P =0.62) and DCR (85.7% versus 81.8%, P =0.73) between the two arms. The median intracranial PFS (iPFS) for icotinib and gefitinib arms were 8.4 months (95% CI, 5.4 to 11.3 months) and 10.6 months (95% CI, 6.3 to 14.8 months), respectively ( P =0.17). Adverse events of the two study arms were generally mild. None of the patients experienced dose reduction of EGFR-TKIs.
Conclusions: Our study showed that icotinib and gefitinib had similar efficacy for brain metastasis of EGFR mutated NSCLC. Large randomized studies are suggested to further illuminate the effect of these two EGFR-TKIs on cerebral lesions of NSCLC.
Figure 1
Figure 2
Figure 3