埃克替尼在老年晚期非小细胞肺癌病人中的疗效及安全性研究

doi:10.3969/j.issn.1003-9198.2021.06.020

Abstract

Abstract: Objective To observe the efficacy and safety of icotinib in the elderly patients with advanced non-small cell lung cancer (NSCLC). Methods A total of 41 advanced NSCLC patients aged >60 years old were retrospectively analyzed from January 2015 to February 2020. Results The clinical data of 41 elderly patients including 28 cases of epidermal growth factor receptor(EGFR) mutation and 13 cases of wild type with advanced NSCLC were enrolled in this study. The patients’ overall objective response rate (ORR) was 53.7% and the disease control rate (DCR) was 80.5%; In the patients with EGFR mutation, ORR was 67.9%, DCR was 92.9%, which were significantly higher than those in the patients with EGFR gene wild type. Single factor analysis showed that EGFR mutation and performance status (PS) score were related with PFS (P<0.05), and multiple Cox regression analysis showed that PS score was the independent influencing factor of the prognosis. The most common adverse events were rash, diarrhea and fatigue. Only 2 patients discontinued the medication due to severe liver injury. Conclusions Icotinib is a safe and effective targeted therapy in the elderly patients with advanced NSCLC, especially in the patients with better PS scores and EGFR mutation.

Key words: non-small cell lung cancer, icotinib, aged, epidermal growth factor receptor, toxicity

CLC Number:

R 734.2

XU Wei, FANG Le-ping, LIU Su-yao, WANG Lin, XU Ju-qing, YANG Shu, WANG Jun, FAN Wei-fei. Efficacy and safety of icotinib in the elderly patients with advanced non-small cell lung cancer[J]. Practical Geriatrics, 2021, 35(6): 612-615.

References

[1] CHEN W, ZHENG R, ZENG H, et al. Annual report on status of cancer in China, 2011[J]. Chin J Cancer Res, 2015, 27(1):2-12.
[2] SCHILLER J H, HARRINGTON D, BELANI C P, et al. Comparison of four chemotherapy regimens for advanced non-small-cell lung cancer[J]. N Engl J Med, 2002, 346(2):92-98.
[3] FUKUOKA M, WU Y L, THONGPRASERT S, et al. Biomarker analyses and final overall survival results from a phase Ⅲ, randomized, open-label, first-line study of gefitinib versus carboplatin/paclitaxel in clinically selected patients with advanced non-small-cell lung cancer in Asia (IPASS)[J]. J Clin Oncol, 2011, 29(21):2866-2874.
[4] ZHOU C, WU Y L, CHEN G, et al. Erlotinib versus chemotherapy as first-line treatment for patients with advanced EGFR mutation-positive non-small-cell lung cancer (OPTIMAL, CTONG-0802): a multicentre, open-label, randomised, phase 3 study[J]. Lancet Oncol, 2011, 12(8):735-742.
[5] REN G J, ZHAO Y Y, ZHU Y J, et al. Tumor gene mutations and messenger RNA expression: correlation with clinical response to icotinib hydrochloride in non-small cell lung cancer[J]. Chin Med J: Engl, 2011, 124(1):19-25.
[6] AL-BATRAN S E, VAN CUTSEM E, OH S C, et al. Quality-of-life and performance status results from the phase Ⅲ RAINBOW study of ramucirumab plus paclitaxel versus placebo plus paclitaxel in patients with previously treated gastric or gastroesophageal junction adenocarcinoma[J]. Ann Oncol, 2016, 27(4):673-679.
[7] THERASSE P, ARBUCK S G, EISENHAUER E A, et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada[J]. J Natl Cancer Inst, 2000, 92(3):205-216.
[8] MOK T S, WU Y L, THONGPRASERT S, et al. Gefitinib or carboplatin-paclitaxel in pulmonary adenocarcinoma[J]. N Engl J Med, 2009, 361(10):947-957.
[9] MAEMONDO M, INOUE A, KOBAYASHI K, et al. Gefitinib or chemotherapy for non-small-cell lung cancer with mutated EGFR[J]. N Engl J Med, 2010, 362(25):2380-2388.
[10]MITSUDOMI T, MORITA S, YATABE Y, et al. Gefitinib versus cisplatin plus docetaxel in patients with non-small-cell lung cancer harbouring mutations of the epidermal growth factor receptor (WJTOG3405): an open label, randomised phase 3 trial[J]. Lancet Oncol, 2010, 11(2):121-128.
[11]ROSELL R, CARCERENY E, GERVAIS R, et al. Erlotinib versus standard chemotherapy as first-line treatment for European patients with advanced EGFR mutation-positive non-small-cell lung cancer (EURTAC): a multicentre, open-label, randomised phase 3 trial[J]. Lancet Oncol, 2012, 13(3):239-246.
[12]SEQUIST L V, YANG J C, YAMAMOTO N, et al. Phase Ⅲ study of afatinib or cisplatin plus pemetrexed in patients with metastatic lung adenocarcinoma with EGFR mutations[J]. J Clin Oncol, 2013, 31(27):3327-3334.
[13]WU Y L, ZHOU C, HU C P, et al. Afatinib versus cisplatin plus gemcitabine for first-line treatment of Asian patients with advanced non-small-cell lung cancer harbouring EGFR mutations (LUX-Lung 6): an open-label, randomised phase 3 trial[J]. Lancet Oncol, 2014, 15(2):213-222.[14]THATCHER N, CHANG A, PARIKH P, et al. Gefitinib plus best supportive care in previously treated patients with refractory advanced non-small-cell lung cancer: results from a randomised, placebo-controlled, multicentre study (Iressa Survival Evaluation in Lung Cancer)[J]. Lancet, 2005, 366(9496):1527-1537.
[15]KIM E S, HIRSH V, MOK T, et al. Gefitinib versus docetaxel in previously treated non-small-cell lung cancer (INTEREST): a randomised phase Ⅲ trial[J]. Lancet, 2008, 372(9652):1809-1818.
[16]CIULEANU T, STELMAKH L, CICENAS S, et al. Efficacy and safety of erlotinib versus chemotherapy in second-line treatment of patients with advanced, non-small-cell lung cancer with poor prognosis (TITAN): a randomised multicentre, open-label, phase 3 study[J]. Lancet Oncol, 2012, 13(3):300-308.
[17]SHEPHERD F A, RODRIGUES PEREIRA J, CIULEANU T, et al. Erlotinib in previously treated non-small-cell lung cancer[J]. N Engl J Med, 2005, 353(2):123-132.
[18]SHI Y, ZHANG L, LIU X, et al. Icotinib versus gefitinib in previously treated advanced non-small-cell lung cancer (ICOGEN): a randomised, double-blind phase 3 non-inferiority trial[J]. Lancet Oncol, 2013, 14(10):953-961.
[19]石远凯,孙燕,丁翠敏,等.中国埃克替尼治疗非小细胞肺癌专家共识[J]. 中国肺癌杂志, 2015, 18(7):397-400.
[20]KRIS M G, JOHNSON B E, BERRY L D, et al. Using multiplexed assays of oncogenic drivers in lung cancers to select targeted drugs[J]. JAMA, 2014, 311(19):1998-2006.
[21]HU X, HAN B, GU A, et al. A single-arm, multicenter, safety-monitoring, phase Ⅳ study of icotinib in treating advanced non-small cell lung cancer (NSCLC)[J]. Lung Cancer, 2014, 86(2):207-212.
[22]PARK J H, KIM T M, KEAM B, et al. Tumor burden is predictive of survival in patients with non-small-cell lung cancer and with activating epidermal growth factor receptor mutations who receive gefitinib[J]. Clin Lung Cancer, 2013, 14(4):383-389.

Efficacy and safety of icotinib in the elderly patients with advanced non-small cell lung cancer

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 15

Metrics

Recommended 10

[1]	LI Jiang, QIU Yan, WANG Ting, WANG Dan, YU Yifan, PU Lingli, BU Ling. Correlation between preoperative SII/ALB and clinicopathologic features in elderly patients with lung adenocarcinoma [J]. Practical Geriatrics, 2024, 38(9): 893-896.
[2]	DAI Jing, CUI Yan. Correlation between glycosylated hemoglobin variability and cognitive dysfunction in elderly patients with type 2 diabetes mellitus [J]. Practical Geriatrics, 2024, 38(9): 931-935.
[3]	ZHENG Hong, QI Zhenbo, XU Peng, XU Jie, YU Xinyu, ZANG Yanan, ZHANG Zhaoyan. Effects of hypnotics on cognition function and daytime sleepiness in the elderly [J]. Practical Geriatrics, 2024, 38(9): 936-939.
[4]	ZHANG Xingxing, ZHANG Haiyang, HE Xiaojing, LU Xiang. Investigation on the relationship between different physical indexes and the risk of diabetes mellitus in the elderly [J]. Practical Geriatrics, 2024, 38(9): 940-943.
[5]	NI Hongyan, CHEN Yun, ZHANG Qibing, MA Yiming, XIE Chenglan. Effects of electroacupuncture on cognitive function and inflammatory factors in elderly patients undergoing lower limb orthopedic surgery during the perioperative period [J]. Practical Geriatrics, 2024, 38(9): 944-947.
[6]	LI Xiaomin, LI Xiaolin, LI Jie, WU Lei, HAO Ranran. Efficiency influencing factors of transanal double-balloon enteroscopy in elderly patients [J]. Practical Geriatrics, 2024, 38(9): 958-961.
[7]	CAI Huicui, CHEN Yan, WANG Yan, YE Jinjun, ZHU Yuying. Effects of diversified health education model with simple respiratory function exercise on cancer-related fatigue and compliance behavior in elderly patients with lung cancer receiving radiotherapy [J]. Practical Geriatrics, 2024, 38(9): 968-972.
[8]	WANG Xiaojiao, WANG Ning, CUI Hong, YE Tong, WANG Xiaoming. Influence of exercise rehabilitation in elderly patients with mild to moderate chronic heart failure [J]. Practical Geriatrics, 2024, 38(8): 775-778.
[9]	SHEN Chenjun, WANG Xiaoqing, TANG Degang, NING Ping. Correlation between standardized uric acid and renal function in elderly patients with chronic kidney disease aged 90 and over [J]. Practical Geriatrics, 2024, 38(8): 779-782.
[10]	HAO Shijie, ZOU Jianpeng, WEI Chen, LIU Qingjiang. Effect of comprehensive respiratory training on hypokinetic dysarthria in elderly patients with Parkinson’s disease [J]. Practical Geriatrics, 2024, 38(8): 783-787.
[11]	XIANG Chao, LUO Caidong. Analysis of the diagnostic value of T wave change of avL lead for the degree of coronary artery stenosis in elderly patients with coronary heart disease [J]. Practical Geriatrics, 2024, 38(8): 788-791.
[12]	LI Huiying, CAI Lili, ZHU Qiwei. Predictive value of plasma N-terminal pro-brain natriuretic peptide for prognosis in patients aged ≥80 years old with left ventricular hypertrophy [J]. Practical Geriatrics, 2024, 38(8): 797-801.
[13]	WANG Xinping, XIE Baimei, WEI Guo, YE Xiaoli, ZHAO Yayun, TAN Xiaotian. Expression levels and clinical significance of serum S100A9 and sCD163 in elderly patients with idiopathic interstitial pneumonia [J]. Practical Geriatrics, 2024, 38(8): 802-807.
[14]	LIU Meijuan, WANG Ning, WANG Dong, LU Fangzhou, LIU Juan. Effect of low-dose lidocaine combined with propofol on motor evoked potential in elderly patients undergoing intracranial tumor resection [J]. Practical Geriatrics, 2024, 38(8): 808-811.
[15]	LI Jingbing, WANG Huijun, WANG Shaoying, ZHAO Can, WANG Lidi, CAO Yujiao. Impacts of pentoxifylline combined with lipoic acid intervention on physical function and quality of life in elderly patients with frailty syndrome [J]. Practical Geriatrics, 2024, 38(8): 812-815.