The Short-term Efficacy Of Icotinib On The Treatment Of Advanced Non-small Cell Lung Cancer

Objective:1.to observe the short-term efficacy and adverse reactions of Icotinib hydrochlorideon the treatment of advanced non-small cell lung cancer(NSCLC)2.to explore whether there are differences in the efficacy of Icotinib hydrochloridein the subgroups of sex, age,smoking history,classification of CEA, histological type,multi-line treatment, the situation of EGFR test and ECOG score.Methods:The study was conducted to collect the138patients with advanced non-small celllung cancer admitted in the Affiliated Hospital of Dalian Medical University fromSeptember1st of2011to June14th of2012.All the cases were confirmed non-small celllung cancer with cytological of histopathological diagnosis.And according to theRECIST criteria,there is one lesion at least which can be measured accurately.All thepatients were required to take Icotinib hydrochloride(125mg three times a day).Thepatients would stop taking Icotinib hydrochloride when the disease of patientsprogressed or the patients cannot tolerate the adverse reaction.During the period oftaking Icotinib hydrochloride,other anti-tumor treatments were not allowed.Thesymptoms of cough,short breath,hemoptysis,pain and so on should be observed.And theimprovements of diet,sleep and physical strength should be recorded.The objectiveefficacy can be evaluated after taking Icotinib hydrochloride for a month or moreaccording to the RECIST criteria.And the adverse reaction related to the treatment canbe assessed on the basis of NCI-CTC3.0.The data and statistical analysis would beprogressed by the application of SPSS17.0.And the comparison of efficacy and adversereaction between groups would be analysed by the use of X~2test.There is statisticalsignificance with P<0.05.The TTP curve would be described by the Kaplane-Meier. Results:There were53males and85females in this study.There were25patients above70years old and113patients below70years old.There were46smokers and92non-smoking patients.There were81patients with abnormal results of CEA and57withnormal CEA results before the treatment of Icotinib hydrochloride.There were36patients(26.1%) using Icotinib hydrochloride as first-line treatment,78patients(56.5%)using Icotinib hydrochloride as second-line treatment,20patients(14.5%)usingIcotinib hydrochloride as third-line treatment,4patients (2.9%)with TKI resistance.Thescores of ECOG PS0~1points：48patients,PS2points:41patients,PS3points:41patients;PS4points:5patients.All the138patients took Icotinib hydrochloride for onemonth at least.And the number of patients with CR was1(0.7%),who was female ofnon-smoking with taking Icotinib hydrochloride as second-line treatment and themutation of EGFR was not clear.The number of patients with PR was59(42.8%),SDwas37(26.8%),PD was41(29.7%).And ORR was43.5%(60/138),DCR70.3%(97/138).The DCR of female was76.5%(65/85),and of malewas49.0%(26/53).The differences of ORR and DCR between the subgroups hadstatistical significance(X~2=6.655，P=0.01；X~2=10.339，P=0.001). The differences ofORR and DCR between the subgroup of patients with above70years old and below70years old had no statistical significance.The differences of ORR and DCR between thesubgroups of patients with smoking and non-smoking had statistical significance(χ2=4.459，P=0.028；X~2=4.426，P=0.026).81patients of abnormal CEA before thetreatment,ORR58.0%(47/81),DCR76.5%(62/81);57patients of normal CEA before thetreatment,ORR14.0%(8/57),DCR45.6%(26/57).The difference of ORR and DCRbetween two subgroups had statistical significance(X~2=27.008，P=0.000；X~2=24.202，P=0.040).There were36patients(26.1%) using Icotinib hydrochloride as first-linetreatment,78patients (56.5%)using Icotinib hydrochloride as second-line treatment,20patients(14.5%)using Icotinib hydrochloride as third-line treatment,4patients(2.9%)with TKI resistance.The difference of DCR between multi-groups had statisticalsignificance(X~2=12.731， P=0.005).45patients with ECOG3~4points,ORR24.4%(11/45),DCR55.6%(25/45),93patients with ECOG0~2points,ORR50.5%(47/93),DCR82.3%(77/93).The difference of ORR and DCR between two groupshad statistical significance(X~2=6.487，P=0.034；X~2=11.671，p=0.001).The mainadverse reactions were rash26.8%,diarrhea13.8%,mild liver function abnormal10.9%. Conclusion:The short-term efficacy of Icotinib hydrochloride on the treatment of advancednon-small cell lung cancer was positive,and relevant adverse reactions were mild.The efficacy of Icotinib hydrochloride on the treatment of patients offemale,non-smoking,higher CEA before treatment,as first-line treatment,lower ECOGscores was better.