Abstract
BackgroundThere are controversial data supporting the efficacy of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) in patients with advanced lung squamous cell carcinoma (SCC). In this study, the efficacy of icotinib in unselected and EGFR‐mutated patients with lung SCC was assessed.MethodsWe retrospectively analyzed the survival time of unselected advanced lung SCC patients treated with icotinib for at least 5 months between June 2013 and June 2016, and selected appropriate EGFR‐mutated advanced lung ADC patients to have 1:1 ratio of propensity score matching with EGFR‐mutated advanced lung SCC patients, and matching factors were age, sex, clinical stage, Karnofsky performance status (KPS), smoking history, EGFR mutation type, and treatment lines.ResultsA total of 487 unselected advanced lung SCC patients were available for analysis of icotinib treatment efficacy. The progression‐free survival (PFS) was 13.0 months (95% CI 12.2‐13.8), the overall survival (OS) was 16.0 months (95% CI 14.7‐17.3), and the objective response rate (ORR) was 41.3%. After propensity score matching, 78 EGFR‐mutated lung SCC and 78 EGFR‐mutated lung ADC patients were selected and compared. Although no statistical difference was found, ADC patients were associated with a longer PFS (15.8 months vs 12.7 months, P = 0.275) and OS (24.2 months vs 18.5 months, P = 0.150), and a better ORR (59.0% vs 48.7%, P = 0.199) than compared with SCC patients when treated with icotinib.ConclusionIcotinib has a modest therapeutic effect in patients with advanced lung SCC, especially for the population with EGFR mutations.
Highlights
There are controversial data supporting the efficacy of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) in patients with advanced lung squamous cell carcinoma (SCC)
48.7%, P = 0.199) than compared with SCC patients when treated with icotinib
Cell lung cancer (NSCLC) constitutes approximately 80% of all lung cancers, and squamous cell carcinoma (SCC) is one of the major subtypes of NSCLC which accounts for approximately 20% to 30%
Summary
We retrospectively analyzed the survival time of unselected advanced lung SCC patients treated with icotinib for at least 5 months between June 2013 and. June 2016, and selected appropriate EGFR-mutated advanced lung ADC patients to have 1:1 ratio of propensity score matching with EGFR-mutated advanced lung SCC patients, and matching factors were age, sex, clinical stage, Karnofsky performance status (KPS), smoking history, EGFR mutation type, and treatment lines. Not all patients with lung SCC were included in the EGFR mutation analysis. Patients received 125 mg oral icotinib three times per day, a treatment cycle is 28 days until intolerable toxicity disease progression or death. The PFS was calculated from the date of initiation of icotinib therapy to the date of tumor progression or any cause of death. The duration of overall survival (OS) was calculated from the date of initiation of icotinib therapy to the date of death
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