Objective To explore the efficacy and safety of icotinib as epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) in treating patients with advanced esophageal squamous cell carcinoma (ESCC) in failure of first-line chemotherapy.

Methods A total of 58 advanced ESCC patients failed to first-line chemotherapy (treatment of platinum combined with paclitaxel or fluorouracil) in the Department of Oncology of Affiliated Hospital of Qinghai University from October 2017 to January 2020 were selected as research objects, and the objective response rate (ORR), disease control rate (DCR) and adverse reactions of orally taken of icotinib were analyzed. Kaplan-Meier survival curve was used to calculate the progression free survival (PFS) and overall survival (OS).

Results Among the 58 advanced ESCC patients with icotinib therapy, 4 cases (6.9%) achieved complete remission (CR), 20 cases (34.5%) achieved partial remission (PR), 21 cases (36.2%) achieved stable disease (SD), and 13 cases (22.4%) developed into tumor progression (PD); the ORR and DCR were 41.4% (24/58) and 77.6% (45/58) respectively. The median PFS was 5.6 months (95%CI, 1.6 to 9.6) and the median OS was 18.5 months (95%CI, 10.2 to 26.8). Fatigue (34.5%), nausea and vomiting (29.3%) and diarrhea (20.7%) were the most common adverse reactions during treatment.

Conclusion Icotinib has good therapeutic effect and safety in treating advanced ESCC patients failed to first-line chemotherapy, which may delay tumor progression and further improve the survival benefit of patients.