Randomized Controlled Trial
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 26, 2022; 10(18): 6069-6081
Published online Jun 26, 2022. doi: 10.12998/wjcc.v10.i18.6069
Sequential chemotherapy and icotinib as first-line treatment for advanced epidermal growth factor receptor-mutated non-small cell lung cancer
Sheng-Jie Sun, Jin-Di Han, Wei Liu, Zhi-Yong Wu, Xiao Zhao, Xiang Yan, Shun-Chang Jiao, Jian Fang
Sheng-Jie Sun, Zhi-Yong Wu, Xiao Zhao, Xiang Yan, Department of Medical Oncology, The Fifth Medical Center of General Hospital of Chinese People's Liberation Army, Beijing 100039, China
Jin-Di Han, Jian Fang, Department of Internal Oncology of Chest, Beijing Cancer Hospital, Beijing 100142, China
Wei Liu, Peking Cancer Hospital Palliative Care Center, Beijing Cancer Hospital, Beijing 100142, China
Shun-Chang Jiao, Department of Oncology, The Fifth Medical Center of General Hospital of Chinese People's Liberation Army, Beijing 100039, China
Author contributions: Sun SJ, Jiao SC, and Fang J carried out the studies, participated in collecting data, and drafted the manuscript; Han JD and Liu W performed the statistical analysis and participated in its design; Wu ZY, Zhao X, and Yan X participated in the acquisition, analysis, interpretation of data and drafted the manuscript; All authors have read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by General Hospital of People's Liberation Army.
Clinical trial registration statement: ClinicalTrials.gov, NCT01665417. Registered on August 12, 2012, https://clinicaltrials.gov/ct2/show/NCT01665417.
Informed consent statement: All patients signed an informed consent form before any study procedure.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Data sharing statement: The raw dataset analyzed in the current study are available from the corresponding author on reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shun-Chang Jiao, MD, Chief Doctor, Department of Oncology, The Fifth Medical Center of General Hospital of Chinese People's Liberation Army, No. 100 West Fourth Ring Road, Fengtai District, Beijing 100039, China. jiaosc@vip.sina.com
Received: November 22, 2021
Peer-review started: November 22, 2021
First decision: February 7, 2022
Revised: March 13, 2022
Accepted: April 15, 2022
Article in press: April 15, 2022
Published online: June 26, 2022
Core Tip

Core Tip: The combination of chemotherapy and epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) (concomitant or intercalated) generally showed improved efficacy compared with EGFR-TKI alone as the first-line treatment for advanced non-small cell lung cancer (NSCLC). This study aimed to evaluate the efficacy and safety of chemotherapy followed by icotinib maintenance therapy as first-line treatment for advanced EGFR-mutated NSCLC. Sixty-eight advanced NSCLC patients were randomized 2:3 to icotinib-alone or chemotherapy plus icotinib. The chemotherapy plus icotinib group showed higher progression-free survival than the icotinib alone group. Our study suggested that the sequential combination of chemotherapy and EGFR-tyrosine kinase inhibitor is feasible for stage IV EGFR-mutated NSCLC patients.