Icotinib is a safe and effective treatment for non-small-cell lung cancer

This study explored the use of icotinib as a first-line treatment for epidermal-growth-factor receptor positive non-small cell lung cancer.

A large percentage of non-small cell lung cancer patients who were never smokers have a genetic mutation that increases the activity of the epidermal-growth-factor receptor. This receptor can increase tumor cell production and migration (the spread of tumor cells beyond the original tumor site). A type of inhibitor, the epidermal-growth-factor receptor tyrosine-kinase inhibitors, can block the activity of these receptors, decreasing tumor growth and spread.

Icotinib (Conmana) is a relatively new epidermal-growth-factor receptor tyrosine-kinase inhibitor which has been shown to be safe and effective for patients with advanced (spread to other areas of the body) non-small cell lung cancer. Previous studies have examined icotinib as a second-line therapy in patients who have already undergone at least one treatment, such as chemotherapy, but whose disease did not respond. The current study examined icotinib as both a first and second-line therapy for patients with advanced non-small cell lung cancer.

This retrospective study (a study which examines data and records already collected) analyzed the outcomes of 24 patients who were treated with icotinib as a first-line treatment (the first treatment tried) and 58 who were treated with icotinib as a second- or third-line treatment. Eight of the first-line patients had the epidermal-growth-factor receptor mutation, and 11 of the second/third-line patients. The overall response (such as tumor shrinkage), progression-free survival (time following treatment before the disease progresses), and overall survival were measured.

63% of the patients with the epidermal-growth-factor receptor mutation showed an overall response, compared to 11% of the patients without the mutation. The average progression-free survival for all patients was 4 months.  Patients with the mutation who received icotinib as a first-line treatment were still progression free at the end of the study (18 months of follow-up), compared to an average of 2 months progression-free survival for the non-mutation patients. For those with the mutation taking icotinib as a second or third-line treatment, progression-free survival was 9 months, compared to 3 months for the non-mutation patients.

Overall survival was also increased for patients with the epidermal-growth-factor receptor mutation: patients taking icotinib as a first-line treatment were still alive at the end of the study, while second- or third-line patients had a 10 month overall survival rate. In patients without the mutation, overall survival was 11 months for the first-line patients and 8 months for the second- or third-line patients.

The use of icotinib significantly reduced the risk of progression by 66% and the risk of death by 90% in those with an epidermal-growth-factor receptor mutation compared to those without.

74.3% of patients experienced an adverse effect while being treated with icotinib. The most common were rash (39% of patients) and diarrhea (20% of patients).

This study concluded that icotinib safely and effectively increased progression free survival and overall survival times in advanced non-small cell lung cancer patients with an epidermal-growth-factor receptor mutation.