Effect of bevacizumab plus double dose icotinib on advanced non-small cell lung cancer with EGFR L858R mutation

e21020 Background: Double-dose icotinib has been proven effective and well tolerated for advanced NSCLC patients with the Epidermal Growth Factor Receptor (EGFR) L858R mutation. For the same patients, the excellent efficacy of bevacizumab combined with erlotinib has been proven in previous studies. In this study, we would investigate the efficacy of the combined therapy bevacizumab and double-dose icotinib for advanced NSCLC patients with EGFR L858R mutation. Methods: 35 patients diagnosed from September 2, 2021 to September 28, 2022 were enrolled in this study and 5 patients were excluded for analysis due to missing efficacy evaluation data. All patients were treated with intravenous bevacizumab (15mg / kg) combined with oral double-dose icotinib (250mg, tid). The primary endpoint was progression-free survival (PFS), and the secondary endpoints were safety, efficacy, and overall survival (OS). Results: Among the 35 patients, 12 were male and 23 were female. The median age at diagnosis was 66. Eight patients were diagnosed with brain metastases. All of the patients have EGFR L858R mutation, and 14 patients were with other coexisting mutations. To the data of December 31, 2022, the median follow-up time was 10 months (range: 3 to 18 months). For 30 patients with complete efficacy evaluation data, 20 patients achieved partial responses (PR), 9 patients had stable disease (SD), and 1 patient developed progress disease (PD). The objective response rate (ORR) was 66.7%, the disease control rate (DCR) was 96.7%, and the median PFS was 14.8 months. For adverse reaction evaluation, the grade 3 adverse events were albuminuria (n = 1) and hepatotoxicity (n = 1). Other adverse events were grade 1-2, mainly oral mucositis, rash, diarrhea and hypertension. Conclusions: The combination of bevacizumab with double-dose icotinib is an effective and relatively safe treatment for advanced NSCLC patients with EGFR L858R mutation. Further exploration will provide more evidence for this type of treatment. Clinical trial information: NCT05263947 .