Guohao Xia, Jifeng Fong, Jianwei Lu

Oncomedical department, Jiangsu Cancer Hospital

Objective:To evaluate the efficacy of treatment with dose-escalated icotinib after resistance to routine dose of icotinib for the patients of the advanced non-smoll cell lung cancer. Method: After resistance to initial dose of icotinib was acquired for the treatment of the advanced non-small cell lung cancer, we escalated the dose of icotinib according to different conditions until disease progression or unacceptable toxic effects. We increased the tablet of icotinib with one by one if the disease was stable (the size of tumor became big or the level of tumor marker increased) or doubled doses if the disease progressed. Patients were assessed for adverse events and response to therapy. Efficacy assessments were performed every 6 weeks. Targeted tumour lesions were assessed with CT scan. Result: We escalated the dose of icotinib in 25 patients after resistance to routine dose of icotinib by three different ways as follow: 8 patients with one by one, 16 patients with double doses and 1 patient with pulsed-wave mode. 2 cases were not able to be evaluated. It was observed 10 patients (43.5%) in partial response (PR), 13 patients (56.5%) in stable disease (SD), 0% in progressive disease (PD). Disease control rate (DCR) was 100%. The median progression free survival (mPFS) was 4.5 months. This therapy was well tolerated generally. Conclusion:The treatment with dose-escalated icotinib might be useful even after resistance to routine dose of icotinib if initial treatment shows a favorable clinical response.

Key Words: non-smoll cell lung cancer  icotinib  dose-escalated