Yun Fan, Gong Lei,  Lulu Miao,  Yanjun Xu, Zhiyu Huang

HangZhou Zhejiang CancerHospitalchemotherapy department

Objective: Theincidence rate of leptomeningeal carcinomatosis (LC) has been increased inadvanced non-small cell lung cancer (NSCLC) patients, especially with EGFRmutations. The purpose of this study was to evaluate the efficacy of icotinibfor the control of LC in NSCLC with sensitive EGFR mutations. Method: Twenty-oneNSCLC patients with sensitive EGFR mutations and cytologically proven LCdiagnoses between 2011 and 2014 at Zhejiang Cancer Hospital were retrospective lyreviewed.Result: Ten patients had exon 21 point mutations and eleven patients hadexon 19 deletional mutations. Sixteen of 21 patients received standard dose oficotinib (125mg/day, three times a day) after LC diagnoses. The other fivepatients had already used icotinib and switchedto double dose oficotinib(250mg/day, three times a day) after LC occurrence. Eight patients receivedintrathecal chemotherapy, and nine of them were treated with combinedwhole-brain radiotherapy. Eighteen of 20 patients (90.0%) showed improvement ofdizziness and headache. Seventeen of 21 patients (80.9%) had an improvedEastern Cooperative Oncology Group performance status (ECOG PS) score aftericotinib treatment. The median overall survival was 10.1 months (95%CI: 8.4–12.0).Univariate analysis showed that the poor ECOGPS score (PS>2), coexistingparenchymal brain metastasis, and the taken of icotinib were unfavorableprognosticfactors for patient survival. The ECOG PS scare was an onlyindependently predictor for survival in the multivariable analysis. Conclusion:This study suggested that icotinib had efficacy for the control of LC inNSCLC with sensitive EGFR mutationsand was well tolerated. The Furtherprospective study is warranted.

KeyWords: Icotinib leptomeningeal carcinomatosis non-small lung cancer