title: Efficacy of icotinib versus traditional chemotherapy as first-line treatment for preventing brain metastasis from advanced lung adenocarcinoma in patients with epidermal growth factor receptor-sensitive mutation.
abstract: OBJECTIVE
  This study aimed to investigate the potential use of icotinib as first-line treatment to prevent brain metastasis from advanced lung adenocarcinoma.
  
  
  METHODS
  This investigation was designed as a retrospective nonrandomized controlled study. Enrolled patients received either icotinib or traditional chemotherapy as their first-line treatment. The therapeutic efficacy was compared among patients with advanced. (stages IIIB and IV) lung adenocarcinoma with epidermal growth factor receptor (EGFR)-sensitive mutation. The primary endpoint was the cumulative incidence of brain metastasis, whereas, the secondary endpoint was overall survival(OS). Death without brain metastasis was considered a competitive risk to calculate the cumulative risk of brain metastasis. Survival analysis was conducted using the Kaplan-Meier method and statistical significance was determined using the log-rank test.
  
  
  RESULTS
  The present study included 396 patients with 131 in the icotinib group and 265 in the chemotherapy group. Among those with EGFR-sensitive mutation, the cumulative risk of brain metastasis was lower in the icotinib group than in the chemotherapy group. However, no significant difference in OS was observed between the two groups.
  
  
  CONCLUSIONS
  Icotinib can effectively reduce the incidence of brain metastasis and therefore improve prognosis in advanced lung adenocarcinoma patients with EGFR.sensitive mutation.
authors.affiliation: Department of Medical Oncology, Affiliated Hospital of PLA General Hospital, Beijing, China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Zhao
authors.affiliation: General Hospital of the Air Force of People's Liberation Army, Beijing, China.
authors.forename: Guangqin
authors.initials: G
authors.lastname: Zhu
authors.affiliation: Second Artillery General Hospital of People's Liberation Army, Beijing, China.
authors.forename: Huoming
authors.initials: H
authors.lastname: Chen
authors.affiliation: Navy General Hospital of People's Liberation Army, Beijing, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Yang
authors.affiliation: General Hospital of People's Liberation Army, Beijing, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Li
authors.affiliation: Department of Medical Oncology, Affiliated Hospital of PLA General Hospital, Beijing, China.
authors.forename: Nan
authors.initials: N
authors.lastname: Du
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality / Q000473:pathology*; D000077192:Adenocarcinoma of Lung; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D043844:Crown Ethers / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004252:DNA Mutational Analysis; D066246:ErbB Receptors / Q000235:genetics; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D009367:Neoplasm Staging; D011799:Quinazolines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents; D043844:Crown Ethers; D011799:Quinazolines; C531470:icotinib; D066246:ErbB Receptors