Abstract 1003
Background
We assessed icotinib as first-line therapy compared with pemetrexed/cisplatine plus pemetrexed maintenance in advanced lung adenocarcinoma patients with sensitizing EGFR mutation.
Methods
This phase 3, open-label, randomized study (CONVINCE) was conducted at 18 sites in China. Eligible patients (pathologically confirmed lung adenocarcinoma, 19/21 EGFR mutation, treatment naive) were 1:1 randomized to receive icotinib (125 mg, three times daily) or pemetrexed (500 mg/m2, day 1) plus cisplatine (75 mg/m2, day 1) every 21 days, non-progressive patients after 4-cycle chemotherapy continue to receive pemetrexed (500 mg/m2, day 1, every 21 days) as maintenance until disease progression or intolerable toxicity. Randomization was stratified by performance status, smoking status, disease stage, and mutation type. The primary endpoint was progression free survival (PFS).
Results
669 patients were screened (January, 2013 to August, 2014), in which 296 were enrolled and randomized (148 for each group), and 285 patients were treated (icotinib: 148, chemotherapy: 137). Patients' characteristics were well balanced between groups. Icotinib significantly improved PFS (9.9 months [95%CI 8.5-11.2] vs 7.3 months [6.0-8.0]; HR 0.65, 95%CI 0.48-0.88, p = 0.004) compared with the chemotherapy group. Subgroup analyses showed the PFS benefit for icotinib persisted among most clinically relevant subgroups (gender, performance status, smoking status, and disease stage), especially in patients harboring EGFR 19del mutation (11.2 months [95%CI 9.2-13.5] vs 7.3 months [5.7-8.4]; p
Conclusions
First-line icotinib offers superior efficacy compared with cisplatine/pemetrexed plus pemetrexed maintenance therapy in advanced lung adenocarcinoma patients with sensitizing EGFR mutation.
Clinical trial identification
ClinicalTrials.Gov NCT01719536.
Legal entity responsible for the study
Betta Pharmaceuticals Co.,Ltd.
Funding
Betta Pharmaceuticals Co.,Ltd.
Disclosure
L. Ding: Salaried, F. Tan: Salaried employee and stock owner of Betta Pharmaceuticals Co.,Ltd. All other authors have declared no conflicts of interest.