Effects of icotinib with and without radiation therapy on patients with EGFR mutant non-small cell lung cancer and brain metastases.
EGFR-TKIs and radiation therapy (RT) are the principal treatment for patients with brain metastases (BM) and EGFR mutant NSCLC. However, the optimal use of brain RT for patients with asymptomatic BM remains undefined. A total of 152 patients were identified. 58 patients were excluded. Of the remaining 97 patients, 56 patients received upfront RT followed by icotinib, including WBRT or SRS. 41 patients received icotinib therapy alone. The mOS from diagnosis of BM was 27.0 months for the whole cohort (95% CI, 23.9-30.1 months). There was no difference in OS between the RT followed by icotinib group and the icotinib alone group (31.9 vs. 27.9 months, P = 0.237), and similar results were found in the SRS subgroup (35.5 vs. 27.9 months, P = 0.12). Patients with the EGFR Del19 mutation had a longer OS than patients with the exon 21 L858R mutation (32.7 vs. 27.4, P = 0.037). Intracranial progression-free survival (PFS) was improved in the patients who received RT followed by icotinib compared to those receiving icotinib alone (22.4 vs. 13.9 months, P = 0.043). Patients with EGFR-mutant adenocarcinoma and BM treated with icotinib exhibited prolonged survival. A longer duration of intracranial control was observed with brain RT.
Wenzhou Medical University, Wenzhou, China.|Department of Thoracic Oncology, Zhejiang Cancer Hospital, Hangzhou, China.|Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology and Cancer Research Institute, Hangzhou, China.
Yun
Y
Fan
Department of Thoracic Oncology, Zhejiang Cancer Hospital, Hangzhou, China.
Yanjun
Y
Xu
Department of Thoracic Oncology, Zhejiang Cancer Hospital, Hangzhou, China.
Lei
L
Gong
Department of Pharmacy, Zhejiang Cancer Hospital, Hangzhou, China.
Luo
L
Fang
Department of Thoracic Oncology, Zhejiang Cancer Hospital, Hangzhou, China.
Hongyang
H
Lu
Department of Thoracic Oncology, Zhejiang Cancer Hospital, Hangzhou, China.
Jing
J
Qin
Department of Thoracic Oncology, Zhejiang Cancer Hospital, Hangzhou, China.
Na
N
Han
Department of Thoracic Oncology, Zhejiang Cancer Hospital, Hangzhou, China.
Fajun
F
Xie
Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, China.
Guoqin
G
Qiu
Department of Thoracic Oncology, Zhejiang Cancer Hospital, Hangzhou, China.
Zhiyu
Z
Huang
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000235:genetics / Q000556:secondary / Q000628:therapy*; D002289:Carcinoma, Non-Small-Cell Lung / Q000235:genetics / Q000473:pathology / Q000628:therapy*; D059248:Chemoradiotherapy / Q000009:adverse effects / Q000379:methods; D043844:Crown Ethers / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D066246:ErbB Receptors / Q000235:genetics*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000235:genetics / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D011799:Quinazolines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016634:Radiosurgery / Q000009:adverse effects / Q000379:methods*
D000970:Antineoplastic Agents; D043844:Crown Ethers; D011799:Quinazolines; C531470:icotinib; C512478:EGFR protein, human; D066246:ErbB Receptors