title: Icotinib might be effective for the treatment of leptomeningeal carcinomatosis in non-small cell lung cancer with sensitive EGFR mutations.
abstract: BACKGROUND
  The incidence of leptomeningeal carcinomatosis (LMC) has increased in patients with metastatic non-small cell lung cancer (NSCLC). This study aimed to evaluate the effect of icotinib in the treatment of LMC.
  
  
  METHODS
  Twenty-one NSCLC patients diagnosed with LMC and treated with icotinib were retrospectively reviewed.
  
  
  RESULTS
  An exon 21 point mutation and an exon 19 deletion of EGFR were found in 10 and 11 patients, respectively. A standard dose of icotinib (125 mg/day, three times a day) was prescribed to 16 patients without previous icotinib therapy. A double dose of icotinib was prescribed to five patients who developed LMC during icotinib therapy with a standard dose. Eighteen of 20 patients showed improvement of dizziness and headache. Seventeen of 21 patients had an improved Eastern Cooperative Oncology Group performance status (ECOG PS) score after icotinib treatment. The median overall survival of the patients after the diagnosis of LMC was 10.1 months (95% confidence interval (CI): 8.4-12.0 months). Univariate analysis showed that the ECOG PS score, parenchymal brain metastasis, and previous icotinib administration were significantly associated with patient survival. Multivariate analysis also demonstrated that the ECOG PS score was an independent predictor for survival.
  
  
  CONCLUSIONS
  Our results suggest that icotinib is effective for the treatment of LMC from NSCLC with an EGFR mutation, especially for patients with a good ECOG PS score.
authors.affiliation: Key Laboratory of Diagnosis and Treatment Technology for Thoracic Oncology (Esophagus, Lung), Zhejiang Cancer Hospital, Zhejiang, People's Republic of China.
authors.forename: Lei
authors.initials: L
authors.lastname: Gong
authors.affiliation: Key Laboratory of Diagnosis and Treatment Technology for Thoracic Oncology (Esophagus, Lung), Zhejiang Cancer Hospital, Zhejiang, People's Republic of China.
authors.forename: Ming
authors.initials: M
authors.lastname: Xiong
authors.affiliation: Key Laboratory of Diagnosis and Treatment Technology for Thoracic Oncology (Esophagus, Lung), Zhejiang Cancer Hospital, Zhejiang, People's Republic of China.
authors.forename: Zhiyu
authors.initials: Z
authors.lastname: Huang
authors.affiliation: Key Laboratory of Diagnosis and Treatment Technology for Thoracic Oncology (Esophagus, Lung), Zhejiang Cancer Hospital, Zhejiang, People's Republic of China.
authors.forename: Lulu
authors.initials: L
authors.lastname: Miao
authors.affiliation: Key Laboratory of Diagnosis and Treatment Technology for Thoracic Oncology (Esophagus, Lung), Zhejiang Cancer Hospital, Zhejiang, People's Republic of China; Wenzhou Medical University, Chashan University Town, Ouhai District, Wenzhou City, Zhejiang Province 325035, People's Republic of China. Electronic address: fanyunzj@163.com.
authors.forename: Yun
authors.initials: Y
authors.lastname: Fan
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000235:genetics* / Q000473:pathology*; D043844:Crown Ethers / Q000627:therapeutic use*; D066246:ErbB Receptors / Q000235:genetics*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000235:genetics* / Q000473:pathology*; D008297:Male; D055756:Meningeal Carcinomatosis / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary*; D008875:Middle Aged; D009154:Mutation; D011799:Quinazolines / Q000627:therapeutic use*; D019233:Retreatment; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D043844:Crown Ethers; D011799:Quinazolines; C531470:icotinib; D066246:ErbB Receptors
keywords: ECOG PS; Epidermal growth factor receptor tyrosine kinase inhibitors; Icotinib; Leptomeningeal carcinomatosis; Non-small cell lung cancer