PATIENTS WITH EGFR-MUTATED LUNG ADENOCARCINOMA AFTER PROGRESSION

Ling Li¹, Jiyuan Tian¹, Haiyan Sun^{2, *}

¹Department of Respiratory, Jinan First People's Hospital, Jinan 250000, Shandong Province, China - ²Department of Respiratory Fever, Dongfang Hospital Beijing University of Chinese Medicine, Beijing 100078, China

Objective: To investigate the clinical efficacy and safety of dose-escalation of icotinib hydrochloride in targeted therapy of epidermal growth factor receptor (EGFR)-mutated lung adenocarcinoma patients after progression. 

Methods: A total of 80 patients with EGFR-mutated lung adenocarcinoma who were diagnosed and treated in our hospital from January 2018 to January 2021 were selected and divided into the control group and the observation group according to the random number table method, with 40 cases in each group. The control group was given docetaxel combined with a conventional dose of icotinib hydrochloride targeted therapy, and the observation group was given an additional dose of icotinib hydrochloride after treatment resistance on the basis of the control group. The clinical efficacy, health status, cancer-related fatigue status, serological indicators, and toxic and side effects were compared between the two groups.

Results: The disease control rate (DCR) in the observation group was significantly higher than that in the control group (P<0.05). After treatment, the levels of CD4+, CD4+/CD8+ in the two groups were significantly lower than those before treatment, and the levels of CD4⁺/CD8⁺ and CD4⁺ were significantly higher than those before treatment (P<0.05). The difference was not statistically significant (P>0.05). After treatment, the Piper fatigue scale (RPFS) score in the observation group was significantly lower than that before treatment and the control group, and the KPS score was significantly higher than that before treatment and the control group (P<0.05). The survival of the observation group was better than that of the control group (χ²=4.240, Lon RankP=0.039). There was no significant difference in the total incidence of toxic and side effects between the two groups (P>0.05). After treatment, the levels of cytokeratin 19 fragment (CYFRA21-1), carcinoembryonic antigen (CEA) and carbohydrate antigen 125 (CA125) in observation group were significantly lower than those before treatment and control group (P<0.05). 

Conclusions: EGFR-mutated lung adenocarcinoma patients who are resistant to icotinib hydrochloride targeted therapy and then given icotinib hydrochloride plus dose therapy have good clinical efficacy. It is not only beneficial to inhibit the proliferation of tumor cells, reduce the tumor volume, improve the prognosis of patients, but also has no obvious malignant effect on the immune function of the body, the treatment effect is relatively safe and effective.