期刊论文详细信息
World Journal of Surgical Oncology
A pilot study: sequential gemcitabine/cisplatin and icotinib as induction therapy for stage IIB to IIIA non-small-cell lung adenocarcinoma
Yue Yang4  Jian Fang2  Yuquan Pei4  Yuzhao Wang4  Yuan Feng4  Jia Wang4  Jinfeng Chen4  Shaolei Li4  Qingfeng Zheng4  Nan Wu4  Shi Yan4  Bingtian Zhao4  Hua Bai3  Fang Fang4  Qin Feng1  Yuanyuan Ma4  Chao Lv4 
[1]Department of Pathology, Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education), Peking University Cancer Hospital and Institute, 52 Fucheng Road, Beijing, Haidian District, 100142, China
[2]Department of Thoracic Medical Oncology II, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, 52 Fucheng Road, Beijing, Haidian District, 100142, China
[3]Department of Thoracic Medical Oncology I, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, 52 Fucheng Road, Beijing, Haidian District, 100142, China
[4]Department of Thoracic Surgery II, Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education), Peking University Cancer Hospital and Institute, 52 Fucheng Road, Beijing, Haidian District, 100142, China
关键词: Adenocarcinoma;    EGFR mutation;    Induction chemotherapy;    Sequential;    Non-small-cell lung cancer;   
Others  :  825535
DOI  :  10.1186/1477-7819-11-96
 received in 2012-12-05, accepted in 2013-04-08,  发布年份 2013
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【 摘 要 】

Background

A phase II clinical trial previously evaluated the sequential administration of erlotinib after chemotherapy for advanced non-small-cell lung cancer (NSCLC). This current pilot study assessed the feasibility of sequential induction therapy in patients with stage IIB to IIIA NSCLC adenocarcinoma.

Methods

Patients received gemcitabine 1,250 mg/m2 on days 1 and 8 and cisplatin 75 mg/m2 on day 1, followed by oral icotinib (125 mg, three times a day) on days 15 to 28. A repeatcomputed tomography(CT) scan evaluated the response to the induction treatment after two 4-week cycles and eligible patients underwent surgical resection. The primary objective was to assess the objective response rate (ORR), while EGFR and KRAS mutations and mRNA and protein expression levels of ERCC1 and RRM1 were analyzed in tumor tissues and blood samples.

Results

Eleven patients, most with stage IIIA disease, completed preoperative treatment. Five patients achieved partial response according to the Response Evaluation Criteria in Solid Tumors (RECIST) criteria (ORR=45%) and six patients underwent resection. Common toxicities included neutropenia, alanine transaminase (ALT) elevation, fatigue, dry skin, rash, nausea, alopecia and anorexia. No serious complications were recorded perioperatively. Three patients had exon 19 deletions and those with EGFR mutations were more likely to achieve a clinical response (P= 0.083). Furthermore, most cases who achieved a clinical response had low levels of ERCC1 expression and high levels of RRM1.

Conclusions

Two cycles of sequentially administered gemcitabine/cisplatin with icotinib as an induction treatment is a feasible and efficacious approach for stage IIB to IIIA NSCLC adenocarcinoma, which provides evidence for the further investigation of these chemotherapeutic and molecularly targeted therapies.

【 授权许可】

   
2013 Lv et al.; licensee BioMed Central Ltd.

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