Comparison of the efficacy and safety of icotinib monotherapy and combined therapy of icotinib and vinorelbine as first-line treatment for advanced lung adenocarcinoma in patients with sensitive EGFR mutations: A retrospective study

Abstract This investigation compares the safety and therapeutic efficiency of icotinib monotherapy and icotinib + vinorelbine combination therapy against non-small cell lung cancer (NSCLC) with EGFR gene mutation. Methods: Data was acquired from105 patients who enrolled in the Fujian Medical University Cancer Hospital between October 2018 and December 2021, including individuals with NSCLC-EGFR mutations who underwent first-line icotinib therapy with or without vinorelbine. Of these 105 cases, 75 patients received icotinib monotherapy (IM), and 35 received icotinib + vinorelbine combination therapy (I+V) and were grouped accordingly. Progression-free survival (PFS) and adverse effects were compared in the two cohorts. Furthermore, the mechanism of drug resistance in the combinational therapy group was also determined. Results: PFS was notably prolonged in the I+V group (12 months vs. 9.3 months, HR=0.501, 95%CI 0.34-0.75, P<0.01). The mechanism of drug resistance was not affected by I+V therapy. Both the disease control and objective response rates in the I+V group were comparable to the IM group. Moreover, increased gastrointestinal reactions were observed in the I+V group thanin the IM group. Conclusions: This study provides information about the effects of combined icotinib and vinorelbine therapy as a first-line strategy for advanced NSCLC patients with EGFR mutations. However, further verification via a prospective phase 3 clinical trialis required.