Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2017 May 16;8(20):33961-33971.
doi: 10.18632/oncotarget.15475.

Clinical efficacy of icotinib in lung cancer patients with different EGFR mutation status: a meta-analysis

Jian Qu  1 , Ya-Nan Wang  2 , Ping Xu  1 , Da-Xiong Xiang  1 , Rui Yang  3 , Wei Wei  4 , Qiang Qu  3
Affiliations
Review

Clinical efficacy of icotinib in lung cancer patients with different EGFR mutation status: a meta-analysis

Jian Qu et al. Oncotarget. .

Abstract

Icotinib is a novel and the third listed epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs), which exerts a good anti-tumor efficacy on non-small cell lung cancer (NSCLC). The efficacy of EGFR-TKIs has been shown to be associated with the EGFR mutation status, especially exon 19 deletion (19Del) and exon 21 L858R mutation. Therefore, a meta-analysis was performed to assess the efficacy of icotinib in NSCLC patients harboring EGFR mutations (19Del or L858R) and wild type (19Del and L858R loci wild type). A total of 24 studies were included for comparing the objective response rate (ORR) in the EGFR wild type and mutant patients treated with icotinib. The ORRs of EGFR mutant patients (19Del or L858R) are better than those of EGFR wild type patients (OR = 7.03(5.09-9.71), P < 0.00001). The pooling ORs from 21 studies on the disease control rate (DCR) in EGFR mutant patients are better than those of EGFR wild type patients (OR = 10.54(5.72-19.43), P < 0.00001). Moreover, the ORRs of EGFR 19Del patients are better than those of EGFR L858R patients after pooling ORs of 12 studies (OR = 2.04(1.12-3.73), P = 0.019). However, there was no significant difference on DCRs of EGFR 19Del patients and those of EGFR L858R patients (OR = 2.01(0.94-4.32), P = 0.072). Our findings indicated that compared with EGFR wild type patients, EGFR mutant patients have better ORRs and DCRs after icotinib treatment; EGFR 19Del patients treated with icotinib have better ORRs than EGFR L858R patients. EGFR mutation status is a useful biomarker for the evaluation of icotinib efficacy in NSCLC patients.

Keywords: disease control rate; epidermal growth factor receptor; icotinib; meta-analysis; objective response rate.

PubMed Disclaimer

Conflict of interest statement

CONFLICTS OF INTEREST

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1. Procedure of article selection
Figure 2
Figure 2. Analysis of risk of bias
Figure 3
Figure 3
Forest plots of studies evaluating odds ratios of ORRs (A), DCRs (B) and DCRs subgroups analysis according to NOS (C) in EGFR wild type and EGFR mutant patients. OR: odds ratio.
Figure 4
Figure 4
Forest plots of studies evaluating odds ratios of ORRs (A), forest plots of studies excluding one publication that influences the overall effective size evaluating odds ratios of ORRs (B) and DCRs (C) in EGFR 19Del and L858R patients. OR: odds ratio.
Figure 5
Figure 5. The funnel plots, Egger's test and Begg's test of publication bias in pooling ORs analysis in EGFR wild type and EGFR mutant patients
(A) The funnel plots, (B) Egger's test and (C) Begg's test for pooling ORs of ORRs analysis; (D) The funnel plots, (E) Egger's test and (F) Begg's test for pooling ORs of DCRs analysis. OR: odds ratio; SE: standard error.
Figure 6
Figure 6. The funnel plots, Egger's test and Begg's test of publication bias in pooling ORs analysis in EGFR 19Del and L858R patients
(A) The funnel plots, (B) Egger's test and (C) Begg's test for pooling ORs of ORRs analysis; (D) The funnel plots, (E) Egger's test and (F) Begg's test for pooling ORs of DCRs analysis. OR: odds ratio; SE: standard error.
Figure 7
Figure 7
The sensitivity analysis of pooling ORs of DCRs in EGFR mutant patients vs. EGFR wild type patients (A) and ORRs in EGFR 19Del and EGFR L858R patients (B). CI: confidence interval.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Jemal A, Siegel R, Xu J, Ward E. Cancer statistics, 2010. CA Cancer J Clin. 2010;60:277–300. - PubMed
    1. Socinski MA, Crowell R, Hensing TE, Langer CJ, Lilenbaum R, Sandler AB, Morris D. American College of Chest P. Treatment of non-small cell lung cancer, stage IV: ACCP evidence-based clinical practice guidelines (2nd edition) Chest. 2007;132:277S–289S. - PubMed
    1. Herbst RS, Heymach JV, Lippman SM. Lung cancer. The N Engl J Med. 2008;359:1367–1380. - PMC - PubMed
    1. Zhou C, Wu YL, Chen G, Feng J, Liu XQ, Wang C, Zhang S, Wang J, Zhou S, Ren S, Lu S, Zhang L, Hu C, et al. Erlotinib versus chemotherapy as first-line treatment for patients with advanced EGFR mutation-positive non-small-cell lung cancer (OPTIMAL, CTONG-0802): a multicentre, open-label, randomised, phase 3 study. Lancet Oncol. 2011;12:735–742. - PubMed
    1. Mitsudomi T, Morita S, Yatabe Y, Negoro S, Okamoto I, Tsurutani J, Seto T, Satouchi M, Tada H, Hirashima T, Asami K, Katakami N, Takada M, et al. Gefitinib versus cisplatin plus docetaxel in patients with non-small-cell lung cancer harbouring mutations of the epidermal growth factor receptor (WJTOG3405): an open label, randomised phase 3 trial. Lancet Oncol. 2010;11:121–128. - PubMed