Related Experiment Video
Updated: Oct 13, 2026
Establishment and Characterization of Three Afatinib-resistant Lung Adenocarcinoma PC-9 Cell Lines Developed with Increasing Doses of Afatinib
Published on: June 26, 2019
Comparative Efficacy of First-Line versus Further-Line Icotinib Therapy in Advanced Lung Adenocarcinoma: A Real-World
Xueli Zhang1,2, Junhui Wang3, Jianxin Chen4
1Department of Pediatrics, Quzhou People's Hospital, The Quzhou Affiliated Hospital, Wenzhou Medical University, Quzhou, Zhejiang, People's Republic of China.
Background:
The optimal sequencing of EGFR tyrosine kinase inhibitors (TKIs) in advanced lung adenocarcinoma remains controversial. This study aimed to compare the efficacy of icotinib as first-line versus further-line therapy in a real-world setting.
Methods:
A retrospective cohort study was conducted at Quzhou People's Hospital involving 45 patients with advanced lung adenocarcinoma, including 40 with EGFR‑mutant (exon 19 deletions or L858R) and 5 with wild‑type EGFR, treated with icotinib between January 2020 and December 2024. Patients were stratified into first-line (n=25) and further-line (n=20) groups. Efficacy endpoints included objective response rate (ORR), progression-free survival (PFS), and overall survival (OS). Multivariate Cox regression analyses adjusted for potential confounders.
Results:
The first-line group demonstrated significantly superior outcomes: ORR 80.0% vs. 30.0% (p=0.0005), median PFS 18.9 months vs. 13.1 months (Cox regression: HR 2.82, 95% CI: 1.18-6.95, p=0.0239), and median OS 51.2 months vs. 35.15 months (Cox regression: HR 3.05, 95% CI: 1.09-8.53, p=0.0339). Multivariate analysis confirmed treatment line as an independent predictor of PFS and OS. Poor ECOG PS (HR 2.65, p=0.0234) and metastatic organs ≥3 (HR 1.77, p=0.0457) were additional negative prognostic factors for OS.
Conclusion:
Icotinib showed better efficacy as first-line therapy than as further-line therapy. However, considering the retrospective, single-center design and small sample size, the results should be interpreted with caution. Baseline clinical factors (ECOG PS and metastatic burden) remained critical for survival outcomes.
