PMID- 28945850
OWN - NLM
STAT- MEDLINE
DCOM- 20180529
LR  - 20220413
IS  - 1569-8041 (Electronic)
IS  - 0923-7534 (Linking)
VI  - 28
IP  - 10
DP  - 2017 Oct 1
TI  - First-line icotinib versus cisplatin/pemetrexed plus pemetrexed maintenance 
      therapy for patients with advanced EGFR mutation-positive lung adenocarcinoma 
      (CONVINCE): a phase 3, open-label, randomized study.
PG  - 2443-2450
LID - S0923-7534(19)34957-9 [pii]
LID - 10.1093/annonc/mdx359 [doi]
AB  - BACKGROUND: Icotinib has been previously shown to be non-inferior to gefitinib in 
      non-selected advanced non-small-cell lung cancer patients when given as second- 
      or further-line treatment. In this open-label, randomized, phase 3 CONVINCE 
      trial, we assessed the efficacy and safety of first-line icotinib versus 
      cisplatin/pemetrexed plus pemetrexed maintenance in lung adenocarcinoma patients 
      with epidermal growth factor receptor (EGFR) mutation. PATIENTS AND METHODS: 
      Eligible participants were adults with stage IIIB/IV lung adenocarcinoma and exon 
      19/21 EGFR mutations. Participants were randomly allocated (1 : 1) to receive 
      oral icotinib or 3-week cycle of cisplatin plus pemetrexed for up to four cycles; 
      non-progressive patients after four cycles were maintained with pemetrexed until 
      disease progression or intolerable toxicity. The primary end point was 
      progression-free survival (PFS) assessed by independent response evaluation 
      committee. Other end points included overall survival (OS) and safety. RESULTS: 
      Between January 2013 and August 2014, 296 patients were randomized, and 285 
      patients were treated (148 to icotinib, 137 to chemotherapy). Independent 
      response evaluation committee-assessed PFS was significantly longer in the 
      icotinib group (11.2 versus 7.9 months; hazard ratio, 0.61, 95% confidence 
      interval 0.43-0.87; P = 0.006). No significant difference for OS was observed 
      between treatments in the overall population or in EGFR-mutated subgroups (exon 
      19 Del/21 L858R). The most common grade 3 or 4 adverse events (AEs) in the 
      icotinib group were rash (14.8%) and diarrhea (7.4%), compared with nausea 
      (45.9%), vomiting (29.2%), and neutropenia (10.9%) in the chemotherapy group. AEs 
      (79.1% versus 94.2%; P < 0.001) and treatment-related AEs (54.1% versus 90.5%; 
      P < 0.001) were significantly fewer in the icotinib group than in the 
      chemotherapy group. CONCLUSIONS: First-line icotinib significantly improves PFS 
      of advanced lung adenocarcinoma patients with EGFR mutation with a tolerable and 
      manageable safety profile. Icotinib should be considered as a first-line 
      treatment for this patient population.
CI  - (c) The Author 2017. Published by Oxford University Press on behalf of the European 
      Society for Medical Oncology. All rights reserved. For permissions, please email: 
      journals.permissions@oup.com.
FAU - Shi, Y K
AU  - Shi YK
AD  - Department of Medical Oncology, Beijing Key Laboratory of Clinical Study on 
      Anticancer Molecular Targeted Drugs, National Cancer Center/Cancer Hospital, 
      Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing. 
      Electronic address: syuankai@cicams.ac.cn.
FAU - Wang, L
AU  - Wang L
AD  - Department of Medical Oncology, Beijing Key Laboratory of Clinical Study on 
      Anticancer Molecular Targeted Drugs, National Cancer Center/Cancer Hospital, 
      Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing.
FAU - Han, B H
AU  - Han BH
AD  - Department of Pulmonology, Shanghai Chest Hospital, Shanghai.
FAU - Li, W
AU  - Li W
AD  - Department of Oncology, The First Hospital Affiliated to Jilin University, 
      Changchun.
FAU - Yu, P
AU  - Yu P
AD  - Department of Lung Cancer Medical Oncology, Sichuan Cancer Hospital, Chengdu.
FAU - Liu, Y P
AU  - Liu YP
AD  - Department of Medical Oncology, The First Hospital of China Medical University, 
      Shenyang.
FAU - Ding, C M
AU  - Ding CM
AD  - Department of Respiratory Medicine, The Fourth Hospital of Hebei Medical 
      University, Shijiazhuang.
FAU - Song, X
AU  - Song X
AD  - Department of Respiratory Medicine, Shanxi Provincial Tumor Hospital, Taiyuan.
FAU - Ma, Z Y
AU  - Ma ZY
AD  - Department of Oncology, Henan Cancer Hospital, Zhengzhou.
FAU - Ren, X L
AU  - Ren XL
AD  - Department of Respiratory Medicine, Xijing Hospital, The Fourth Military Medical 
      University, Xi'an.
FAU - Feng, J F
AU  - Feng JF
AD  - Department of Oncology, Jiangsu Cancer Hospital, Nanjing.
FAU - Zhang, H L
AU  - Zhang HL
AD  - Department of Oncology, Tangdu Hospital, The Fourth Military Medical University, 
      Xi'an.
FAU - Chen, G Y
AU  - Chen GY
AD  - Department of Medical Oncology, The Affiliated Tumor Hospital of Harbin Medical 
      University, Harbin.
FAU - Han, X H
AU  - Han XH
AD  - Department of Medical Oncology, Beijing Key Laboratory of Clinical Study on 
      Anticancer Molecular Targeted Drugs, National Cancer Center/Cancer Hospital, 
      Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing.
FAU - Wu, N
AU  - Wu N
AD  - Department of Imaging Diagnosis, National Cancer Center/Cancer Hospital, Chinese 
      Academy of Medical Sciences and Peking Union Medical College, Beijing.
FAU - Yao, C
AU  - Yao C
AD  - Department of Biostatistics, Peking University Clinical Research Institute, 
      Beijing.
FAU - Song, Y
AU  - Song Y
AD  - Department of Respiratory Medicine, Jinling Hospital, Nanjing University School 
      of Medicine, Nanjing.
FAU - Zhang, S C
AU  - Zhang SC
AD  - Department of Medical Oncology, Beijing Chest Hospital, Capital Medical 
      University, Beijing.
FAU - Song, W
AU  - Song W
AD  - Department of Radiology, Peking Union Medical College Hospital, Beijing.
FAU - Liu, X Q
AU  - Liu XQ
AD  - Department of Pulmonary Oncology, The 307th Hospital of Chinese People's 
      Liberation Army, Beijing.
FAU - Zhao, S J
AU  - Zhao SJ
AD  - Department of Imaging Diagnosis, National Cancer Center/Cancer Hospital, Chinese 
      Academy of Medical Sciences and Peking Union Medical College, Beijing.
FAU - Lin, Y C
AU  - Lin YC
AD  - Department of Medical Oncology, Cancer Hospital of Shantou University Medical 
      College, Shantou.
FAU - Ye, X Q
AU  - Ye XQ
AD  - Department of Respiratory Diseases, The Second Affiliated Hospital of Nanchang 
      University, Nanchang.
FAU - Li, K
AU  - Li K
AD  - Department of Thoracic Oncology, Tianjin Medical University Cancer Institute and 
      Hospital, Tianjin.
FAU - Shu, Y Q
AU  - Shu YQ
AD  - Department of Oncology, Jiangsu Provincial Hospital, Nanjing.
FAU - Ding, L M
AU  - Ding LM
AD  - Betta Pharmaceuticals Co., Ltd, Hangzhou, China.
FAU - Tan, F L
AU  - Tan FL
AD  - Betta Pharmaceuticals Co., Ltd, Hangzhou, China.
FAU - Sun, Y
AU  - Sun Y
AD  - Department of Medical Oncology, Beijing Key Laboratory of Clinical Study on 
      Anticancer Molecular Targeted Drugs, National Cancer Center/Cancer Hospital, 
      Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing.
LA  - eng
SI  - ClinicalTrials.gov/NCT01719536
PT  - Clinical Trial, Phase III
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PL  - England
TA  - Ann Oncol
JT  - Annals of oncology : official journal of the European Society for Medical 
      Oncology
JID - 9007735
RN  - 0 (Crown Ethers)
RN  - 0 (Quinazolines)
RN  - 04Q9AIZ7NO (Pemetrexed)
RN  - 9G6U5L461Q (icotinib)
RN  - EC 2.7.10.1 (EGFR protein, human)
RN  - EC 2.7.10.1 (ErbB Receptors)
RN  - Q20Q21Q62J (Cisplatin)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Antineoplastic Combined Chemotherapy Protocols/adverse effects/*therapeutic use
MH  - Cisplatin/administration & dosage/adverse effects
MH  - Crown Ethers/adverse effects/*therapeutic use
MH  - ErbB Receptors/*genetics/metabolism
MH  - Exons
MH  - Female
MH  - Humans
MH  - Lung Neoplasms/*drug therapy/enzymology/genetics/pathology
MH  - Maintenance Chemotherapy
MH  - Male
MH  - Middle Aged
MH  - Mutation
MH  - Neoplasm Staging
MH  - Pemetrexed/administration & dosage/adverse effects
MH  - Quinazolines/adverse effects/*therapeutic use
OTO - NOTNLM
OT  - EGFR mutation-positive
OT  - NSCLC
OT  - cisplatin/pemetrexed plus pemetrexed maintenance
OT  - first-line
OT  - icotinib
EDAT- 2017/09/26 06:00
MHDA- 2018/05/31 06:00
CRDT- 2017/09/26 06:00
PHST- 2017/09/26 06:00 [pubmed]
PHST- 2018/05/31 06:00 [medline]
PHST- 2017/09/26 06:00 [entrez]
AID - S0923-7534(19)34957-9 [pii]
AID - 10.1093/annonc/mdx359 [doi]
PST - ppublish
SO  - Ann Oncol. 2017 Oct 1;28(10):2443-2450. doi: 10.1093/annonc/mdx359.