Adjuvant Icotinib in EGFR-mutated stage IB non-small cell lung cancer with high-risk factors: A retrospective case series

TL;DR

A study found that adjuvant icotinib improved disease-free survival in high-risk EGFR-mutated stage IB lung cancer patients with minimal side effects.

Contribution

This is the first retrospective case series to evaluate adjuvant icotinib in high-risk EGFR-mutated stage IB NSCLC patients.

Findings

3-year disease-free survival rate was 91.4% in high-risk EGFR-mutated stage IB NSCLC patients treated with adjuvant icotinib.

Two patients with recurrence successfully switched to osimertinib after developing T790M mutations.

Adverse events were mostly mild (grade 1–2), with no severe or higher-grade events observed.

Abstract

Primary results of the CORIN trial indicated that, compared with chemotherapy, icotinib significantly improved 3-year disease-free survival (DFS) in patients with Epidermal Growth Factor Receptor (EGFR)-mutated stage IB non-small cell lung cancer (NSCLC). However, evidence regarding the outcomes of adjuvant icotinib in patients with high-risk factors remains limited. This retrospective study evaluated the efficacy and safety of adjuvant icotinib in patients with EGFR-mutated high-risk stage IB NSCLC. We enrolled 37 patients with completely resected EGFR-mutated high-risk stage IB NSCLC. The median follow-up time was 31 months, and the 3-year DFS rate was 91.4%. Two patients experienced disease recurrence and were successfully switched to osimertinib upon identification of an EGFR (T790M) mutation. Although overall survival (OS) and central nervous system (CNS)-DFS data were not mature, no deaths or central nervous system metastases were observed by the end of follow-up. 29 (78.4%) patients experienced grade 1–2 adverse events (AEs), no grade 3 or higher AEs occurred. This study suggests a potential DFS benefit and well-tolerated profile of adjuvant icotinib in patients with EGFR-mutated high-risk stage IB NSCLC. However, longer-term follow-up is necessary to assess the long-term outcomes.

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