| BackgroundNow non-small cell lung cancer(NSCLC)is the most harmful cancer to human,s health and life. About 70 percent patients have been in the advanced stage when they were first diagnosed, therefore they have no chance to have a surgery,then chemotherapy,radiotherapy and so on must be taken into consideration.However, patients trend to progress soon after receiving their first-line treatment.At this time,if they choose the traditional chemotherapy drugs again,more adverse reactions will occur and easy to get drug resistance. With the study of genes and signal transduction, molecular targeted therapy provides another idea for the treatment of malignant tumors. Some researchers pointed out that the main targets is the epidermal growth factor receptor(EGFR) in the treatment of NSCLC, which belongs to the tyrosine kinase receptor.It have an important role one the apoptosis of tumor cells, the proliferation cell division.Then we have developed and launched some targeted gefitinib, erlotinib and erlotinib. Due to the shorter time of the create of Icotinib, there is no credible reports about its overall survival datas in the second-line treatment of lung cancer.This paper takes the overall survival time as the main outcome measure to compare the efficacy and safety of Icotinib hydrochloride and docetaxel as second-line treatment for advanced lung cancer. ObjectiveBoth Icotinib and docetaxel, as the second-line treatment for the advanced lung adenocarcinoma patients, were effective drugs.There was no reliable report about the overall survival time of icotinib in the second-line treatment of advanced lung adenocarcinoma patients.The overall survival as the main outcome measure in this paper in order to compare the efficacy and toxicity between Icotinib and docetaxel as second-line treatment in advanced lung adenocarcinoma patients. MethodsA restrospective study was performed on 121 advanced lung adenocarcinoma patients who had progressed on first line platinum-based therapies from October 1st 2011 to April 1st 2014.Among them,79 case taked icotinib 125 mg tid,and the other 42 cases were given infusion docetaxel 75mg/m2 d1 q21d(4-6 cycles) until the disease progressed or severe adverse events occurred when the best supportive care should be given.We observed the progress free survival(PFS),the overall survival(OS),the disease control rate(DCR),the objective response rate(ORR)and toxicity. ResultsIn icotinib group whose EGFR status were unknown 4(10.8%)cases received partial response(PR),18(48.7%) cases achieved stable disease(SD),15(40.5%) cases showed progressive disease(PD).The ORR was 10.8%,and the DCR was 59.5%,the mPFS was 2.9 months,and the mOS was 10.0 months.In the docetaxel group,there were 6(14.3%) cases of PR,20(47.6%) patients of SD,16(38.1%) patients of PD.The ORR and DCR was 14.3% and 61.9%.The mPFS and mOS was 3.2 months and 8.2 months.continued until the tumor progression or the.The two groups had similar ORR(?2=0.015, P=0.901), DCR(?2=0.049, P=0.824), PFS(?2=0.191,P=0.662)and OS(?2=1.249,P=0.264). In the Icotinib group who with EGFR mutation-positive had a higher DCR(90.5%,P=0.001),a longer PFS(12.2 months,P=0.000) and OS(19.5 months, P=0.001) than in the EGFR status unknown group.When comparing EGFR mutation-positive group with docetaxel group,we observe another higher ORR(?2=7.244,P=0.007)and higher DCR(?2=9.450,P=0.002)and longer PFS(?2=21.219,P=0.000)and longer OS(?2=25.525,P=0.000).In the icotinib group, patients showed a low rate of severe adverse events,had a better security. ConclusionsFirstly, Icotinib has a similar efficacy and fewer adverse events in the second-line treatment for the advanced lung adenocarcinoma whose EGFR status were unknown, but achieving a lower adverse reaction.Secondly,compared with docetaxel, people who with EGFR mutation can significantly prolonged overall survival, get more clinical benefit and a better life.Thirdly,EGFR mutation is a predicted factor for the efficacy of Icotinib. |
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