Icotinib, an EGFR-TKI, for the treatment of brain metastases in non-small cell lung cancer: a retrospective study

Abstract

Abstract Objective Treatment of brain metastases from non-small cell lung cancer (NSCLC) is a challenge because of the poor prognosis. Icotinib is a new type of oral epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) used in the treatment of advanced NSCLC. The aim of this study was to evaluate the efficacy of icotinib in NSCLC patients with brain metastasis. Methods This study reviewed records of 51 NSCLC patients with brain metastases who took icotinib 125 mg, 3 times a day. Response rate, progression free survival, and overall survival were analyzed. SPSS software version 17.0 was used for univariate analysis, and Cox regression analysis to analyze factors affecting survival. Results Thirty-six cases had partial response, 6 cases had stable disease, and 10 cases had progressive disease. In 31 cases, EGFR gene mutation test were performed. EGFR was mutated in 26 cases and was with wild-type in 5 cases. In patients with EGFR mutations, 23 patients responded to icotinib [the disease control rate (DCR) was 88.5%], significantly higher than in patients with wild-type EGFR (1 patient, DCR 20%) (P = 0.005). The overall median progression-free survival (PFS) was 7.6 months. PFS was longer in the patients with EGFR mutations than in those with wild type EGFR (7.8 months vs 1.2 months, P = 0.03). The overall median overall survival (OS) time was 10.7 months. OS was longer in patients with EGFR mutations than in those with wild type EGFR (15.1 months vs 6.7 months, P = 0.003). The main side effects of the treatment were skin rash and diarrhea; no stage 3 or 4 toxic effects occurred. Univariate analysis demonstrated that OS was related to sex, Eastern Cooperative Oncology Group performance status (ECOG PS), smoking history, and EGFR mutation. Multivariate analysis showed that OS was independently related to sex, ECOG PS, and EGFR mutations. Conclusion Icotinib has a favorable effect on NSCLC patients with brain metastases harboring EGFR mutations. Icotinib can be a new choice of treatment for brain metastases in patients with NSCLC harboring EGFR mutations.