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Esophageal cancer at 70 plus? Icotinib plus radiation

Background

Concurrent chemoradiation therapy remains the standard therapy for unresectable Esophageal Squamous Cell Carcinoma patients.

However, its feasibility and efficiency for older patients are being challenged. Serious acute toxic effects, such as hematologic toxicity, esophagiti, and pneumonitis, were commonly observed.

In a retrospective analysis, only 33.3% of older patients completed chemoradiation, whereas 68.3% of nonelderly patients completed it.

Treatment-related death was suspected in up to 18% of patients older than 75 years who underwent chemo plus radiation, even when both chemotherapy and radiotherapy were reduced in dose and field when necessary. Concurrent chemoradiation therapy showed no superiority over radiation alone in survival.

About EGFR in Esophageal Squamous Cell Carcinoma

Epidermal growth factor receptor, EGFR, is overexpressed in 30% to 70% of patients with Esophageal Squamous Cell Carcinoma and is associated with poor prognosis and an inferior response to standard treatment.

Immunohistochemistry, IHC, is the test performed to analyze EGFR expression.

About Icotinib

Icotinib (trade name Conmana) is a highly selective tyrosine kinase inhibitor (EGFR-TKI) and administered orally.

Icotinib is approved for use as first-line monotherapy in patients with Non-Small-Cell Lung Cancer, NSCLC, with somatic EGFR mutations.

Currently, it is solely approved and marketed in China.

About the Study

To this phase II clinical trial 27 patients 70 years or older with Esophageal Squamous Cell Carcinoma were enrolled to receive radiotherapy plus Icotinib or radiotherapy alone.

Results

Side Effects

In this study, Icotinib plus radiotherapy was tolerable in older patients with Esophageal Squamous Cell Carcinoma.

No difference was observed in severe side effects.

Conclusion

The best treatment for a cancer patient is to get the most advanced cancer drugs in advanced stages of development. There, the hope and the chance to extend life go far beyond the standard protocols.

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Esophageal cancer - Icotinib plus radiation
Esophageal cancer – Icotinib plus radiation

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