369P - Comparison of the efficacy and safety of icotinib with vinorelbine or without vinorelbine as first-line treatment for advanced lung adenocarcinoma in patients with sensitive EGFR mutations: A retrospective study

Background

EGFR-TKIs offer significantly greater efficacy than chemotherapy in patients with TKI sensitive EGFR mutations, TKIs are now the first line therapy for advanced lung adenocarcinoma in patients with sensitive EGFR mutations. Despite the high efficacy of these kinase inhibitors, radical cure of stage IV NSCLC remains an unachieved goal because invariably, almost all patients develop acquired resistance within one to several years. Constant efforts have been made to search strategy for overcoming resistance to kinase inhibitors, such as combined anti-vascular or combined chemotherapy. Metronomic chemotherapy is based on the chronic administration of chemotherapeutic agents at low, minimally toxic doses and with no drug-free breaks. EGFR-TKIs combined vinorelbine may be a strategy to delay resistance. The present retrospective work focused on analyzing the effect of icotinib in the presence or absence of icotinib on advanced NSCLC cases harboring EGFR mutation.

Methods

Data were collected retrospectively from the Fujian Medical University Cancer Hospital between October 2018 and December 2021, where the NSCLC cases that harbored EGFR mutations underwent first-line therapy with icotinib in the presence or absence of vinorelbine. This study included 105 cases, of which 70 patients were in the icotinib group and 35 in the icotinib plus vinorelbine group. We compared progression from survival (PFS) and adverse events between the groups.

Results

PFS did not differ between the two groups (12.3 months vs. 10.0 months, HR = 1.652, 95%CI 0.72–2.02, P = 0.596). The objective response rate and the disease control rate for the combination group were significantly higher than those for the icotinib only group. Substantially higher incidences of gastrointestinal reaction were observed in the combined group compared to the icotinib monotherapy group.

Conclusions

This is the first study to provide further evidence of applying icotinib in combination with vinorelbine as first-line treatment for advanced NSCLC cases harboring EGFR mutations. However, these findings need to be verified through prospective phase 3 clinical studies.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Fujian Cancer Hospital.

Funding

Has not received any funding.

Disclosure

The author has declared no conflicts of interest.