Analysis Of The Efficacy Of First-generation TKI Targeted Drugs In Patients With EGFR Mutations In Advanced Lung Adenocarcinoma

Objective The efficacy and safety of icotinib and gefitinib in the treatment of advanced EGFR mutation-positive lung adenocarcinoma were retrospectively analyzed.Methods A collection of 154 patients with advanced lung adenocarcinoma with EGFR(exon 19 or 21)mutations who were treated of first-line at the General Hospital of Ning Xia Medicial University from January 2014 to September 2019 were collected.Among them,83 patients received oral icotinib(125 mg 3 times/day);71 patients received oral gefitinib(250mg once/day)until the disease progressed or showed intolerable drug toxicity.Observe the patient’s ORR,DCR,median PFS,and adverse reactions.Results 1.83 patients in the icotinib group had an ORR of 61.4% and a DCR of 88.0%;71 patients in the gefitinib group had an ORR of 56.3% and a DCR of 84.5%.The ORR(P=0.520)and DCR(P=0.535)of the two groups were similar,and there was no statistical difference.2.The median PFS of patients in the icotinib group and gefitinib group were 8.4months and 7.9 months respectively(P=0.030),there was a statistical difference.3.59 patients with EGFR exon 19 mutations,among them the ORR of the icotinib group was68.8%,and the DCR was 90.6%;the ORR of the gefitinib group was 66.7%,and the DCR was 88.9%;the ORR of the two groups(P=0.865)and DCR(P=0.826)are similar,and there is no statistical difference.4.95 patients with EGFR exon 21 mutations,among them the ORR of the icotinib group was 54.9%,and the DCR was 84.3%;the ORR of the gefitinib group was 50.0%,and the DCR was 84.1%;the ORR of the two groups(P=0.633)and DCR(P=0.976)are similar,there is no statistical difference.5.Among patients with EGFR exon 19 mutations,the median PFS of the two groups were 9.3 months and 8.2 months respectively(P=0.012),the difference was statistically significant.6.Among patients with EGFR exon 21 mutations,the median PFS of the two groups were 7.8 months and 7.5 months,respectively(P=0.550),and the difference was not statistically significant.7.The side effects of the two targeted drugs include skin rash,diarrhea,abnormal liver function,and nausea/anorexia,all of which are mainly grade 1～2.The incidence of adverse reactions above grade 3 is low,and there is no treatment due to serious adverse reactions.Interruption or death,safety and tolerability are better.Conclusion 1.Gefitinib and icotinib have no significant difference in improving the ORR and DCR of patients with advanced lung adenocarcinoma with EGFR mutations;Icotinib can improve the median PFS of patients with EGFR exon 19 mutations than gefitinib.Significantly.2.The safety and tolerability of the two drugs are better.