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N. Xu



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    P2.11 - Poster Session 2 - NSCLC Novel Therapies (ID 209)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
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      P2.11-017 - Icotinib in advanced lung adenocarcinoma patients pretreated with pemetrexed (ID 1604)

      09:30 - 09:30  |  Author(s): N. Xu

      • Abstract

      Background
      In non-small cell lung cancer (NSCLC), the well-developed epidermal growth factor receptor (EGFR) is important therapeutic target. EGFR activating gene mutations have been proved strongly predictive of response to EGFR-tyrosine kinase inhibitors in NSCLC. However, both in daily clinical practice and clinical trials, patients with unknown EGFR gene status (UN-EGFR-GS) are very common. In this study, we assessed efficacy and tolerability of sequential treatment of first-line pemetrexed followed by icotinib in Chinese advanced lung adenocarcinoma with UN-EGFR-GS.

      Methods
      We retrospectively analyzed 15 patients with advanced lung adenocarcinoma, who were treated first-line chemotherapy with pemetrexed and sequential using icotinib. The clinical characteristics, toxicity and survival status were collected through reviewing medical records, electronic preserved data, interviewing with patients or their family members. The overall survival (OS) was defined as the time of starting pemetrexed treatment to death or lost to follow up. The clinical course of included patients and treatment were prospectively monitored.

      Results
      Totally, 15 patients with advanced lung adenocarcinoma were included, 9 females, 6 males. The median age is 57 years old (ranges: 40-73y). Of the 15 patients, 11 were non-smokers and 4 were smokers. All the patients at least received one cycle of pemetrexed chemotherapy, and then were administered with icotinib. Four cases were received pemetrexed combined with carboplatin, 8 combined with cisplatin, and 3 as single use. The mean cycles of pemetrexed given to patients were 3.8(1-6cycles). The response rate to pemetrexed was 20.0% (3/15), stable disease 33.3% (5/15), progressive disease 40% (6/15). The icotinib use of 4 patients was for the purpose of maintenance therapy, 11 for second line. The response rate to icotinib was 40% (6/15), stable disease 26.7% (4/15), progressive disease 33.3% (5/15). There was no grade 3-4 toxicities observed during icotinib treatment phase. The most common grade 1-2 toxicities were rashes (26.7%), diarrheas (30%), elevated aminotransferase (13.3%) and elevated BUN (6.7%). At the end of follow up, 8 patients were dead, 7 alive. The median OS was 22.6 months. Two patients were still on icotinib treatment.

      Conclusion
      The sequence of first-line pemetrexed-based chemotherapy followed by icotinib treatment is a promising option for advanced lung adenocarcinoma with UN-EGFR-GS in China. The sequence yielded promising results with acceptable toxicity. The role of the sequential model for advanced NSCLC patients with adenocarcinoma histology should be further investigated in studies with larger sample sizes.