Efficacy And Safety Of Icotinib Dose Increase In Treating Patients With Egfr-Positive Lung Adenocarcinoma With Progression After Regular Icotinib Treatment

Objective: To investigate the efficacy and safety of icotinib dose increase in treating patients with EGFR-positive lung adenocarcinoma with progression after regular icotinib treatment.Methods: A total of 92 patients with EGFR-positive lung adenocarcinoma, who developed progression after taking icotinib, 125 mg per time, three times daily and were treated in our hospital from June 2015 to July 2016, were enrolled in the study. They were randomly divided into the pemetrexed group and the icotinib dose increase group-46 patients per group. The patients in the pemetrexed group were given pemetrexed on day 1, 500 mg/m2, three weeks per treatment course, for four successive courses in total. They were given folic acid (400 mu g daily) and vitamin B12 (1000 mu g daily) prior to taking pemetrexed. Additionally, they were also given dexamethasone, 5 mg per time, one day before pemetrexed treatment. The patients in the icotinib dose increase group took icotinib hydrochloride tablets orally, 250 mg daily, 3 times/day, three weeks per treatment course, for four successive courses in total. The short-term efficacy, progression-free survival (PFS), overall survival (OS), and incidence of adverse reactions were compared between the two groups.Results: The objective response rate and disease control rate of the patients were 28.26% and 78.26% in the icotinib dose increase group, respectively, and 13.04% and 65.22% in the pemetrexed group, respectively. There was no statistical significance between the two groups (P>0.05). The median OS and median PFS were 10.31 and 3.62 months in the icotinib dose increase group, respectively, and 10.01 and 3.31 months in the pemetrexed group, respectively. There was no significant difference between the two groups (P>0.05). The incidence of adverse reactions was 52.17% in the icotinib dose increase group and 78.64% in the pemetrexed group. The difference between the two groups was statistically significant (P<0.05).Conclusions: There was no significant difference in the short-term clinical effects, PFS, and OS between icotinib and pemetrexed in treating patients with EGFR-positive adenocarcinoma. However, the adverse reactions of icotinib were significantly reduced. Dose increase of icotinib may become a second-line treatment for patients with EGFR-positive lung adenocarcinoma.