Sequential chemotherapy and icotinib as first-line treatment for advanced epidermal growth factor receptor-mutated non-small cell lung cancer

Table 1 Patient characteristics

	Icotinib	Chemotherapy + icotinib	Chemotherapy + icotinib, n = 34
			2DP	2PP	4DP	4PP
	n = 22	n = 34	n = 11	n = 10	n = 4	n = 9
Age (yr)	57.0 ± 7.4	52.7 ± 11.05	52.9 ± 11.5	49.8 ± 9.2	49.8 ± 13.7	57.1 ± 11.7
Sex
Male	11 (50.0)	9 (26.5)	2 (18.2)	2 (20.0)	2 (50.0)	3 (33.3)
Female	11 (50.0)	25 (73.5)	9 (81.8)	8 (80.0)	2 (50.0)	6 (66.7)
Stage
IIIB	0	1 (2.9)	0	0	0	1 (11.1)
IV	22 (100.0)	33 (97.1)	11 (100.0)	10 (100.0)	4 (100.0)	8 (88.9)
EGFR mutation
19 Del	12 (54.5)	19 (55.9)	5 (45.5)	5 (50.0)	4 (100.0)	5 (55.6)
21 L858R	7 (31.8)	14 (41.2)	5 (45.5)	5 (50.0)	0	4 (44.4)
Other	3 (13.6)	1 (2.9)	1 (9.1)	0	0	0
Smoking
Yes	6 (27.3)	4 (11.8)	1 (9.1)	1 (10.0)	1 (25.0)	1 (11.1)
No	15 (68.2)	30 (88.2)	10 (90.9)	9 (90.0)	3 (75.0)	8 (88.9)
Quit smoking	1 (4.5)	0	0	0	0	0
ECOG PS
0	5 (22.7)	6 (17.6)	1 (9.1)	2 (20.0)	0	3 (33.3)
1	13 (59.1)	25 (73.5)	7 (63.6)	8 (80.0)	4 (100.0)	6 (66.7)
2	2 (9.1)	0	0	0	0	0
Other	2 (9.1)	3 (8.8)	3 (27.3)	0	0	0

Data are mean ± SD or number (%). EGFR: Epithelial growth factor receptor; ECOG PS: Eastern Cooperative Oncology Group performance status.

Table 2 Response to treatment

	n	PR (95%CI)	SD (95%CI)	PD (95%CI)	NE (95%CI)	ORR (95%CI)	DCR (95%CI)
Icotinib	22	54.5 (32.2-75.6)	36.4 (17.2-59.3)	4.5 (0.1-22.8)	4.5 (0.1-22.8)	54.5 (32.2-75.6)	90.9 (70.8-98.9)
Chemotherapy + icotinib	34	44.1 (27.2-62.1)	52.9 (35.1-70.2)	2.9 (0.1-15.3)		44.1 (27.2-62.1)	97.1 (84.7-99.9)
2-cycle chemo	21	47.6 (25.7-70.2)	52.4 (29.8-74.3)			47.6 (25.7-70.2)	100.0 (83.9-100.0)
2DP	11	36.4 (10.9-69.2)	63.6 (30.8-89.1)			36.4 (10.9-69.2)	100.0 (71.5-100.0)
2PP	10	60.0 (26.2-87.8)	40.0 (12.2-73.8)			60.0 (26.2-87.8)	100.0 (69.2-100.0)
4-cycle chemo	13	38.5 (13.9-68.4)	53.8 (25.1-80.8)	7.7 (0.2-36.0)		38.5 (13.9-68.4)	92.3 (64.0-99.8)
4DP	4	50.0 (6.8-93.2)	50.0 (6.8-93.2)			50.0 (6.8-93.2)	100.0 (39.8-100.0)
4PP	9	33.3 (7.5-70.1)	55.6 (21.2-86.3)	11.1 (0.3-48.2)		33.3 (7.5-70.1)	88.9 (51.8-99.7)
DP	15	40.0 (16.3-67.7)	60.0 (32.3-83.7)			40.0 (16.3-67.7)	100.0 (78.2- 100.0)
PP	19	47.4 (24.4-71.1)	47.4 (24.4-71.1)	5.3 (0.1-26.0)		47.4 (24.4-71.1)	94.7 (74.0-99.9)
Total	56	48.2 (34.7-62.0)	46.4 (33.0-60.3)	3.6 (0.4-12.3)	1.8 (0.0-9.6)	48.2 (34.7-62.0)	94.6 (85.1-98.9)

DCR: Disease control rate; NE: Not evaluable; ORR: Overall response rate; PD: Progressive disease; PR: Partial response; SD: Stable disease.

Table 3 Subsequent treatments

	Icotinib	Chemotherapy + icotinib	Chemotherapy + icotinib, n = 34
			2DP	2PP	4DP	4PP
	n = 22	n = 34	n = 11	n = 10	n = 4	n = 9
Chemotherapy	13 (59.1)	16 (47.1)	6 (54.6)	4 (40.0)	2 (50.0)	4 (44.4)
Osimertinib	10 (45.5)	17 (50.0)	6 (54.6)	4 (40.0)	2 (50.0)	5 (55.6)
Other TKI	2 (9.1)	3 (8.8)	1 (9.1)	0	0	2 (22.2)
Radiotherapy	3 (13.6)	7 (20.6)	1 (9.1)	3 (30.0)	2 (50.0)	2 (22.2)
Other	3 (13.6)	5 (14.7)	1 (9.1)	2 (20.0)	0	2 (22.2)

TKI: Tyrosine kinase inhibitor.

Table 4 Possible treatment-related adverse events

	All-grade TRAE		Grade 3-4 TRAE
	Icotinib (n = 22)	Chemotherapy + icotinib (n = 34)	Icotinib (n = 22)	Chemotherapy + icotinib (n = 34)
Rash	9 (40.9)	19 (55.9)	0 (0.0)	0 (0.0)
Gastrointestinal system disorders	0 (0.0)	28 (82.4)	0 (0.0)	2 (5.9)
Alanine transaminase elevation	6 (27.3)	14 (41.2)	0 (0.0)	0 (0.0)
Aspartate aminotransferase elevation	3 (13.6)	10 (29.4)	0 (0.0)	0 (0.0)
Leukopenia	0 (0.0)	22 (64.7)	0 (0.0)	3 (8.8)
Thrombocytopenia	0 (0.0)	4 (11.8)	0 (0.0)	0 (0.0)

TRAE: Treatment-related adverse event.