Icotinib, a selective EGF receptor tyrosine kinase inhibitor, for the treatment of non-small-cell lung cancer
Abstract
ABSTRACT
Advanced non-small-cell lung cancer (NSCLC) is the main cause for cancer-related mortality. Treatments for advanced NSCLC are largely palliative and a benefit plateau appears to have reached with the platinum-based chemotherapy regimens. EGF receptor (EGFR) tyrosine kinase inhibitors gefitinib, erlotinib and afatinib came up with prolonged progression-free survival and improved quality of life, especially in EGFR-mutated patients. Icotinib is an oral selective EGFR tyrosine kinase, which was approved by China Food and Drug administration in June 2011 for treating advanced NSCLC. Its approval was based on the registered Phase III trial (ICOGEN), which showed icotinib is noninferior to gefitinib. This review will discuss the role of icotinib in NSCLC, and its potential application and ongoing investigations.
Papers of special note have been highlighted as: • of interest; •• of considerable interest
References
- 1 . Cancer statistics, 2013. CA Cancer J. Clin. 63(1), 11–30 (2013).
- 2 Report of incidence and mortality in China cancer registries, 2009. Chin. J. Cancer Res. 25(1), 10–21 (2013).
- 3 Changing epidemiology of small-cell lung cancer in the United States over the last 30 years: analysis of the surveillance, epidemiologic, and end results database. J. Clin. Oncol. 24(2), 4539–4544 (2006).
- 4 Epidermal growth factor (EGF) receptor kinase-independent signaling by EGF. J. Biol. Chem. 276(18), 15554–15560 (2001).
- 5 . The epidermal growth factor receptor and its inhibition in cancer therapy. Pharmacol. Ther. 82, 241–250 (1999).
- 6 . Untangling the ErbB signalling network. Nat. Rev. Mol. Cell Biol. 2, 127–137 (2001).
- 7 . American College of Chest Physicians. Treatment of non-small cell lung cancer stage I and stage II: ACCP evidence-based clinical practice guidelines (2nd Edition). Chest 132(3 Suppl.), S234–S242 (2007).
- 8 Eastern Cooperative Oncology Group: comparison of four chemotherapy regimens for advanced non-small-cell lung cancer. N. Engl. J. Med. 346(2), 92–98 (2002).
- 9 . Following the crumbs: from tissue samples, to pharmacogenomics, to NSCLC therapy. Transl. Lung Cancer Res. 2(4), 256–258 (2003).
- 10 Gefitinib versus docetaxel in previously treated non-small-cell lung cancer (INTEREST): a randomised Phase III trial. Lancet 372(9652), 1809–1818 (2008).
- 11 Erlotinib in previously treated non-small-cell lung cancer. N. Engl. J. Med. 353, 123–132 (2005).
- 12 Gefitinib versus cisplatin plus docetaxel in patients with non-small-cell lung cancer harboring mutations of the epidermal growth factor receptor (WJTOG3405): an open label, randomized Phase 3 trial. Lancet Oncol. 11(2), 121–128 (2010).
- 13 Gefitinib or chemotherapy for non-small-cell lung cancer with mutated EGFR. N. Engl. J. Med. 362(25), 2380–2388 (2010).
- 14 Erlotinib versus chemotherapy as first-line treatment for patients with advanced EGFR mutation-positive non-small-cell lung cancer (OPTIMAL, CTONG-0802): a multicentre, open-label, randomised, Phase 3 study. Lancet Oncol. 12(8), 735–742 (2011).
- 15 Erlotinib versus standard chemotherapy as first-line treatment for European patients with advanced EGFR mutation-positive non-small-cell lung cancer (EURTAC): a multicentre, open-label, randomised Phase 3 trial. Lancet Oncol. 13(3), 239–246 (2012).
- 16 Gefitinib or carboplatin–paclitaxel in pulmonary adenocarcinoma. N. Engl. J. Med. 361(10), 947–957 (2009).
- 17 Phase III study of afatinib or cisplatin plus pemetrexed in patients with metastatic lung adenocarcinoma with EGFR mutations. J. Clin. Oncol. 31(27), 3327–3334 (2013).
- 18 Symptom control and quality of life in LUX-Lung 3: a Phase III study of afatinib or cisplatin/pemetrexed in patients with advanced lung adenocarcinoma with EGFR mutations. J. Clin. Oncol. 31(27), 3342–3350 (2013).
- 19 Icotinib versus gefitinib in previously treated advanced non-small-cell lung cancer (ICOGEN): a randomised, double-blind Phase 3 non-inferiority trial. Lancet Oncol. 14(10), 953–961 (2013).• This paper reported the registered, Phase III randomized controlled trial (ICOGEN) in which noninferiority of icotinib to gefitinib was established. Based on this study, icotinib was approved in China for unselected non-small-cell lung cancer patients as second-line or multiple-line treatment.
- 20 Safety and efficacy results of a Phase IV, open-label, multicenter, safety-monitoring study of icotinib in treating advanced non-small cell lung cancer (NSCLC): ISAFE study. Presented at: 2013 ASCO Annual Meeting. Chicago, IL, USA, 31 May–4 June 2013.
- 21 Synthesis and biological evaluation of crown ether fused quinazoline analogues as potent EGFR inhibitors. Bioorg. Medicin. Chem. Lett. 22(19), 6301–6305 (2012).
- 22 Ubiquitin ligase Cbl-b is involved in icotinib (BPI-2009H)-induced apoptosis and G1 phase arrest of EGFR mutation-positive non-small-cell lung cancer. Biomed. Res. Int. 2013, 726375 (2013).
- 23 Icotinib, a potent and specific EGFR tyrosine kinase inhibitor, inhibits growth of squamous cell carcinoma cell line A431 through negatively regulating AKT signaling. Biomed. Pharmacother. 67(5), 351–356 (2013).
- 24 Zhejiang Beta Pharma Ltd. ZL03108814.7 (2007).
- 25 Icotinib (BPI-2009H), a novel EGFR tyrosine kinase inhibitor, displays potent efficacy in preclinical studies. Lung Cancer 76(2), 177–182 (2012).•• Demonstrated the antitumor activities of icotinib at molecular and cell level.
- 26 . In vivo cytotoxicity effects of CIK cells combined with icotinib against lung adenocarcinoma cells. Acta Univers. Med. Anhui 48(8), 893–897 (2013).
- 27 Icotinib increases the sensitivity of gastric cancer cells to tumor necrosis factor-related apoptosis-inducing ligand. Modern Oncol. 21(6), 1174–1177 (2013).
- 28 . Metabolite identification of a new antitumor agent icotinib in rats using liquid chromatography/tandem mass spectrometry. Rapid Commun. Mass Spectrom. 22(14), 2176–2184 (2008).
- 29 Clinical pharmacokinetics of Icotinib, an anti-cancer drug: evaluation of dose proportionality, food effect, and tolerability in healthy subjects. Cancer Chemother. Pharmacol. 73(4), 721–727 (2014).
- 30 Phase I study of icotinib hydrochloride (BPI-2009H), an oral EGFR tyrosine kinase inhibitor, in patients with advanced NSCLC and other solid tumors. Lung Cancer. 73(2), 195–202 (2011).•• Paper about both the pharmacokinetics and activity of icotinib in heavily treated non-small-cell lung cancer patients, the recommended dose for Phase III study was also established in this study.
- 31 ZD1839, a selective oral epidermal growth factor receptor–tyrosine kinase inhibitor, is well tolerated and active in patients with solid, malignant tumors: results of a Phase I trial. J. Clin. Oncol. 20(9), 2240–2250 (2002).
- 32 Phase I and pharmacologic study of OSI-774, an epidermal growth factor receptor tyrosine kinase inhibitor, in patients with advanced solid malignancies. J. Clin. Oncol. 19(13), 3267–3279 (2001).
- 33 Phase I study of continuous afatinib (BIBW 2992) in patients with advanced non-small cell lung cancer after prior chemotherapy/erlotinib/gefitinib (LUX-Lung 4). Cancer Chemother. Pharmacol. 69(4), 891–899 (2012).
- 34 . The effects of icotinib hydrochloride on rat CYP450. Presented at: 9th Conference on Chineses Drug and Xenobiotics Metabolism. Wuhan, China, October 24–26 2009.
- 35 . Effect of the CYP2C19 genotype on the pharmacokinetics of icotinib in healthy male volunteers. Eur. J. Clin. Pharmacol. 68(12), 1677–1680 (2012).
- 36 Efficacy of icotinib for advanced non-small cell lung cancer patients with EGFR status identified. Zhongguo Fei Ai Za Zhi 16(3), 138–143 (2013).
- 37 An open-label, dose-escalating, Phase I trial to evaluate the tolerability and antitumor activity of icotinib in patients with advanced non-small-cell lung cancer. Presented at: 15th World Conference on Lung Cancer (15th WCLC). Sydney, Australia, 27–30 October 2013.
- 38 Phase I trial of icotinib, a novel epidermal growth factor receptor tyrosine kinase inhibitor, in Chinese patients with non-small cell lung cancer. Chin. Med. J. (Engl.) 124(13), 1933 (2011).
- 39 Clinical observation from the treatment of icotinib for 196 cases with advanced non-small cell lung cancer. Presented at: 15th World Conference on Lung Cancer (15th WCLC). Sydney, Australia, 27–30 October 2013.
- 40 A pilot study: sequential gemcitabine/cisplatin and icotinib as induction therapy for stage IIB to IIIA non-small-cell lung adenocarcinoma. World J. Surg. Oncol. 11, 96 (2013).
- 41 Clinical observation of icotinib hydrochloride in first-line therapy for pulmonary adenocarcinoma. Chin. J. Lung Cancer 16(7), 364–368 (2013).
- 42 Tumor gene mutations and messenger RNA expression: correlation with clinical response to icotinib hydrochloride in non-small cell lung cancer. Chin. Med. J. (England) 124(1), 19–25 (2011).
- 43 Icotinib Versus First-line Chemotherapy Plus Maintenance Treatment in EGFR Positive Lung Adenocarcinoma Patients (Convince). www.clinicaltrials.gov/ct2/show/NCT01719536?term=NCT01719536&rank=1.
- 44 Icotinib Treat the Patient With Brain Metastasis Epidermal Growth Factor Receptor (EGFR) Mutant Non Small Cell Lung Cancer Comparing With Whole Brain Radiotherapy (BRAIN). www.clinicaltrials.gov/ct2/show/NCT01724801?term=NCT01724801&rank=1.
- 45 Afatinib versus placebo for patients with advanced, metastatic non-small-cell lung cancer after failure of erlotinib, gefitinib, or both, and one or two lines of chemotherapy (LUX-Lung 1): a Phase 2b/3 randomised trial[J]. Lancet Oncol. 13(5), 528–538 (2012).
- 46 Activating mutations in the epidermal growth factor receptor underlying responsiveness of non-small-cell lung cancer to gefitinib. N. Engl. J. Med. 350(21), 2129–2139 (2004).
- 47 EGF receptor gene mutations are common in lung cancers from “never smokers” and are associated with sensitivity of tumors to gefitinib and erlotinib. Proc. Natl Acad. Sci. USA 101(36), 13306–13311 (2004).
- 48 Network meta-analysis of erlotinib, gefitinib, afatinib and icotinib in patients with advanced non-small-cell lung cancer harboring EGFR mutations. PLoS ONE 9(2), e85245 (2014).
- 49 Afatinib for patients with lung adenocarcinoma and epidermal growth factor receptor mutations (LUX-Lung 2): a Phase 2 trial. Lancet Oncol. 13(5), 539–548 (2012).
- 50 Phase III study of afatinib or cisplatin plus pemetrexed in patients with metastatic lung adenocarcinoma with EGFR mutations. J. Clin. Oncol. 31(27), 3327–3334 (2013).
- 51 Erlotinib as maintenance treatment in advanced non-small-cell lung cancer: a multicentre, randomised, placebo-controlled Phase 3 study. Lancet Oncol. 11(6), 521–529 (2010).
- 52 Gefitinib versus placebo as maintenance therapy in patients with locally advanced or metastatic non-small-cell lung cancer (INFORM; C-TONG 0804): a multicentre, double-blind randomised Phase 3 trial. Lancet Oncol. 13(5), 466–475 (2012).
- 53 A double-blind, randomised, placebo-controlled Phase III intergroup study of gefitinib in patients with advanced NSCLC, non-progressing after first line platinum-based chemotherapy (EORTC 08021/ILCP 01/03). Eur. J. Cancer 47(15), 2331–2340 (2011).
- 54 Impact on disease-free survival of adjuvant erlotinib or gefitinib in patients with resected lung adenocarcinomas that harbor epidermal growth factor receptor (EGFR) mutations. J. Thorac Oncol. 6(3), 569–575 (2011).
- 55 O28.01 select biomarker analyses of completely resected NSCLC tumors from enrolled patients in an adjuvant erlotinib (Tarceva) clinical trial (RADIANT). Presented at: 14th World Conference on Lung Cancer (WCLC). Amsterdam, The Netherlands, 6 July 2011.
- 56 Pemetrexed-carboplatin adjuvant chemotherapy with or without gefitinib in resected stage IIIA-N2 non-small cell lung cancer harbouring EGFR mutations: a randomized, Phase II study. Ann. Surg. Oncol. 2014, 1–6 (2014).
- 57 Efficacy of icotinib for advanced non-small cell lung cancer patients with EGFR status identified. Zhongguo Fei Ai Za Zhi 16(3), 138–143 (2013).
- 58 Kinetic analysis of epidermal growth factor receptor somatic mutant proteins shows increased sensitivity to the epidermal growth factor receptor tyrosine kinase inhibitor, erlotinib. Cancer Res. 66(16), 8163–8171 (2006).
- 59 BIBW2992, an irreversible EGFR/HER2 inhibitor highly effective in preclinical lung cancer models. Oncogene 27(34), 4702–4711 (2008).
- 60 . Pharmacoeconomic evaluation of EGFR-TKIs in the treatment of advanced non-small cell lung cancer. Chin. J. Drug Eval. 30(5), 305–308 (2013).