In:
Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 35, No. 15_suppl ( 2017-05-20), p. e20658-e20658
Abstract:
e20658 Background: To compare the efficacy of first-line icotinib or chemotherapy plus icotinib maintenance in EGFR-mutated NSCLC patients, and analyze the correlation between changes in cytokine levels and survival. Methods: Treatment-naive patients with EGFR-mutated NSCLC were enrolled and randomly assigned to recieve icotinib or 2- or 4-cycle chemotherapy (pemetrexed + platinum [PP] or docetaxel + platinum [DP]) with icotinib maintenance. The primary endpoints were progression-free survival (PFS). Plasma samples were collected at baseline and after 6-week treatment. Cytokines, including interleukin-2 (IL-2), interleukin-6 (IL-6), transforming growth factor (TGF), programmed death (PD) 1, PD-ligand (PD-L) 1, cytotoxic T lymphocyte-associated antigen-4 (CTLA-4), and hypoxia-inducible factor-1 (HIF-1), were tested by ELISA. Results: 66 eligible patients were enrolled (November, 2011 to June, 2016), in which 56 patients were treated, including 20 patients receiving icotinib [PFS: 8.17 months (5.5-13.97)] , 11 patients receiving 2-cycle chemotherapy (DP) followed by icotinib maintenance [PFS: 12.07 (6.2-12.83)], 10 patients receiving 2-cycle chemotherapy (PP) followed by icotinib maintenance [PFS: 15.37 (4.03-NR)] , 4 patients receiving 4-cycle chemotherapy (DP) followed by icotinib maintenance [PFS: 15.37 (7.13-NR)], 9 patients receiving 4-cycle chemotherapy (PP) followed by icotinib maintenance [PFS: 13.82 (1.5-22.93)] . Samples were collected from 20 patients. The shift of level was seen in all cytokines and multivariate analysis showed that the change of IL-6, HIF, PD-L1, and PD1 were associated with significantly longer survival in patients with EGFR-mutated NSCLC. Conclusions: First-line chemotherapy plus icotinib maintenance seems to offer better efficacy in advanced NSCLC patients with EGFR mutation. The shift of level of IL-6, HIF-1, PD 1, and PD-L1 in peripheral blood correlates with a better prognosis, however, further study with larger size is warranted to detect the potential role of immune response in regulating survival of patients with EGFR-mutant NSCLC. Clinical trial information: NCT01665417.
Type of Medium:
Online Resource
ISSN:
0732-183X
,
1527-7755
DOI:
10.1200/JCO.2017.35.15_suppl.e20658
Language:
English
Publisher:
American Society of Clinical Oncology (ASCO)
Publication Date:
2017
detail.hit.zdb_id:
2005181-5
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