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Efficacy, safety and economy of icotinib for advanced non-small cell lung cancer: a meta-analysis

Yan Bian & Jisheng Chen*

Aim: To evaluate the efficacy and safety of Icotinib in the treatment of advanced Non-small Cell Lung Cancer (NSCLC). Design: Comprehensive retrieved PubMed, EMBase, Cochrane Library, CBM, CNKI, Weipu database and Wangfang database. Randomized controlled trials (RCT) about Icotinib (test group) versus Gefitinib or Erlotinib(control group) in the treatment of advanced NSCLC. The quality of included studies was evaluated and Meta-analysis was conducted. Setting: Icotinib, Erlotinib and Gefitinib belong to the first generation of EGFR-TKI. Three are now used in the treatment of advanced non-small cell lung cancer. Results: Totally 10 RCTs were enrolled, involving 1188 patients. Results of Meta-analysis showed there were no significant differences in the overall response rate (OR=1.16, 95%CI(0.90, 1.50), p=0.25), the disease control rate (OR=1.24, 95%CI(0.96, 1.60), p=0.10), the incidence of diarrhea (OR=0.76, 95%CI(0.55, 1.05), p=0.10) and the incidence of hepatic dysfunction(OR=0.45, 95%CI(0.18, 1.12), p=0.09) between 2 groups; the incidence of rash in the Icotinib group was significantly lower than the control group, there was significant difference (OR=0.68, 95%CI(0.52, 0.90), p=0.006). And the cost-effect ratio of Icotinib group has obvious advantages compared with Gefitinib and Erlotinib group. Conclusions: Based on present domestic clinical evidence, the efficacy of Icotinib for advanced NSCLC is comparable to Gefitinib or Erlotinib, but it’s incidence of rash was significantly lower than Gefitinib or Erlotinib, the tolerance of patients from Icotinib group is superior to Gefitinib or Erlotinib. Icotinib has obvious cost advantage and can be used as a routine drug choice for chemotherapy in advanced NSCLC.