Clinical efficacy of icotinib in lung cancer patients with different EGFR mutation status: a meta-analysis
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Jian Qu1,*, Ya-Nan Wang2,*, Ping Xu1, Da-Xiong Xiang1, Rui Yang3, Wei Wei4, Qiang Qu3
1Department of Pharmacy, the Second Xiangya Hospital, Central South University, Institute of Clinical Pharmacy, Central South University, Changsha 410078, P.R.China
2Department of Respiratory, Hospital of Laiwu Iron and Steel Co.Ltd, Laiwu 271100, P.R.China
3Department of Pharmacy, Xiangya Hospital, Central South University, Changsha 410078, P.R.China
4Department of General Surgery, Xiangya Hospital, Central South University, Changsha 410008, P.R.China
*These authors contributed equally to this work
Jian Qu, email: [email protected]
Qiang Qu, email: [email protected]
Keywords: icotinib, epidermal growth factor receptor, meta-analysis, objective response rate, disease control rate
Received: November 11, 2016 Accepted: February 07, 2017 Published: February 18, 2017
Icotinib is a novel and the third listed epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs), which exerts a good anti-tumor efficacy on non-small cell lung cancer (NSCLC). The efficacy of EGFR-TKIs has been shown to be associated with the EGFR mutation status, especially exon 19 deletion (19Del) and exon 21 L858R mutation. Therefore, a meta-analysis was performed to assess the efficacy of icotinib in NSCLC patients harboring EGFR mutations (19Del or L858R) and wild type (19Del and L858R loci wild type). A total of 24 studies were included for comparing the objective response rate (ORR) in the EGFR wild type and mutant patients treated with icotinib. The ORRs of EGFR mutant patients (19Del or L858R) are better than those of EGFR wild type patients (OR = 7.03(5.09–9.71), P < 0.00001). The pooling ORs from 21 studies on the disease control rate (DCR) in EGFR mutant patients are better than those of EGFR wild type patients (OR = 10.54(5.72–19.43), P < 0.00001). Moreover, the ORRs of EGFR 19Del patients are better than those of EGFR L858R patients after pooling ORs of 12 studies (OR = 2.04(1.12–3.73), P = 0.019). However, there was no significant difference on DCRs of EGFR 19Del patients and those of EGFR L858R patients (OR = 2.01(0.94–4.32), P = 0.072). Our findings indicated that compared with EGFR wild type patients, EGFR mutant patients have better ORRs and DCRs after icotinib treatment; EGFR 19Del patients treated with icotinib have better ORRs than EGFR L858R patients. EGFR mutation status is a useful biomarker for the evaluation of icotinib efficacy in NSCLC patients.
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