{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T12:03:38Z","timestamp":1793361818711,"version":"4.5.0"},"reference-count":38,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,6,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Neurofibromatosis type 2 (NF2) is a rare autosomal dominant syndrome associated primarily with bilateral vestibular schwannomas (VSs). Conventional surgical or radiosurgical treatments for VS in NF2 usually result in high risks of hearing loss and facial nerve impairment, while there is no validated medical option to date. This single-institution phase II study evaluated the efficacy and safety of icotinib, an oral epidermal growth factor receptor tyrosine kinase inhibitor, in patients with NF2 and progressive VS.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>Icotinib was administered daily at 375 mg orally in a continuous 28-day course for up to 12 courses. The primary endpoint of the study was radiographic response assessed by brain MRI using 3D volumetric tumor analysis and defined as a \u2265 20% decrease in VS volume. Hearing function was evaluated as a secondary endpoint, with response defined as a statistically significant increase in word recognition scores.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Ten eligible patients with a mean age of 23.8 years were enrolled. One patient (10%) with bilateral tumors experienced an objective radiographic response (\u221223.58% and \u221222.01%). Three (43%) of 7 patients met the hearing response criteria. At 12 months, the estimated progression-free survival was 82.0% (95% CI 42.3%\u201395.5%) for volumetric progression and 69.2% (95% CI 37.3%\u221287.2%) for hearing progression. Common mild to moderate adverse events included rash (90%), diarrhea (50%), myalgia (20%), and nausea\/gastrointestinal pain (20%).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Icotinib carries minor toxicity and is associated with radiographic and hearing responses in patients with NF2 and progressive VS.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2022.9.jns22699","type":"journal-article","created":{"date-parts":[[2022,10,21]],"date-time":"2022-10-21T12:44:52Z","timestamp":1666356292000},"page":"1680-1687","source":"Crossref","is-referenced-by-count":12,"title":["Phase II trial of icotinib in adult patients with neurofibromatosis type 2 and progressive vestibular schwannoma"],"prefix":"10.3171","volume":"138","author":[{"given":"Fu","family":"Zhao","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"Department of Neural Reconstruction, Beijing Neurosurgical Institute, Capital Medical University; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shi-wei","family":"Li","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Li","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Neuro-Oncology, Sanbo Brain Hospital, Capital Medical University, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-bin","family":"Zhao","sequence":"additional","affiliation":[{"name":"Nuclear Medicine, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Hong","family":"Wang","sequence":"additional","affiliation":[{"name":"Otolaryngology, Beijing Tiantan Hospital, Capital Medical University;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neural Reconstruction, Beijing Neurosurgical Institute, Capital Medical University; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Wang","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pi-nan","family":"Liu","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"},{"name":"Department of Neural Reconstruction, Beijing Neurosurgical Institute, Capital Medical University; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"2","key":"b1","series-title":"Am J Med Genet A","first-page":"327","article-title":"Birth incidence and prevalence of tumor-prone syndromes: estimates from a UK family genetic register service","volume":"152A","author":"Evans DG","year":"2010","unstructured":"Evans DG, Howard E, Giblin C,  Birth incidence and prevalence of tumor-prone syndromes: estimates from a UK family genetic register service. Am J Med Genet A. 2010;152A(2):327\u2013332.20082463"},{"issue":"9679","key":"b2","series-title":"Lancet","first-page":"1974","article-title":"Neurofibromatosis type 2","volume":"373","author":"Asthagiri AR","year":"2009","unstructured":"Asthagiri AR, Parry DM, Butman JA,  Neurofibromatosis type 2. Lancet. 2009;373(9679):1974\u20131986.19476995"},{"issue":"2","key":"b3","series-title":"J Neurosurg","first-page":"217","article-title":"Predictors of vestibular schwannoma growth in patients with neurofibromatosis Type 2","volume":"96","author":"Baser ME","year":"2002","unstructured":"Baser ME, Makariou EV, Parry DM. Predictors of vestibular schwannoma growth in patients with neurofibromatosis Type 2. J Neurosurg. 2002;96(2):217\u2013222.11838793"},{"key":"b4","series-title":"Prog Neurol Surg","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1159\/000156905","article-title":"Microsurgery management of vestibular schwannomas in neurofibromatosis type 2: indications and results","volume":"21","author":"Samii M","year":"2008","unstructured":"Samii M, Gerganov V, Samii A. Microsurgery management of vestibular schwannomas in neurofibromatosis type 2: indications and results. Prog Neurol Surg. 2008;21:169\u2013175.18810216"},{"issue":"2","key":"b5","series-title":"J Neurooncol","first-page":"417","article-title":"Surgical treatment of large vestibular schwannomas in patients with neurofibromatosis type 2: outcomes on facial nerve function and hearing preservation","volume":"138","author":"Zhao F","year":"2018","unstructured":"Zhao F, Wang B, Yang Z,  Surgical treatment of large vestibular schwannomas in patients with neurofibromatosis type 2: outcomes on facial nerve function and hearing preservation. J Neurooncol. 2018;138(2):417\u2013424.29492767"},{"issue":"3","key":"b6","series-title":"Otol Neurotol","first-page":"466","article-title":"Surgical management of vestibular schwannomas and hearing rehabilitation in neurofibromatosis type 2","volume":"33","author":"Tysome JR","year":"2012","unstructured":"Tysome JR, Macfarlane R, Durie-Gair J,  Surgical management of vestibular schwannomas and hearing rehabilitation in neurofibromatosis type 2. Otol Neurotol. 2012;33(3):466\u2013472.22334163"},{"issue":"7","key":"b7","series-title":"Otol Neurotol","first-page":"1163","article-title":"Management strategy of vestibular schwannoma in neurofibromatosis type 2","volume":"32","author":"Odat HA","year":"2011","unstructured":"Odat HA, Piccirillo E, Sequino G, Taibah A, Sanna M. Management strategy of vestibular schwannoma in neurofibromatosis type 2. Otol Neurotol. 2011;32(7):1163\u20131170.21817944"},{"issue":"3","key":"b8","series-title":"Neurosurgery","first-page":"460","article-title":"Stereotactic radiosurgery for vestibular schwannomas in patients with neurofibromatosis type 2: an analysis of tumor control, complications, and hearing preservation rates","volume":"60","author":"Mathieu D","year":"2007","unstructured":"Mathieu D, Kondziolka D, Flickinger JC,  Stereotactic radiosurgery for vestibular schwannomas in patients with neurofibromatosis type 2: an analysis of tumor control, complications, and hearing preservation rates. 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J Clin Oncol. 2019;37(35):3446\u20133454.31626572"},{"issue":"2","key":"b14","series-title":"Neurol Med Chir (Tokyo)","first-page":"75","article-title":"Bevacizumab therapy of neurofibromatosis type 2 associated vestibular schwannoma in Japanese patients","volume":"60","author":"Fujii M","year":"2020","unstructured":"Fujii M, Ichikawa M, Iwatate K,  Bevacizumab therapy of neurofibromatosis type 2 associated vestibular schwannoma in Japanese patients. Neurol Med Chir (Tokyo). 2020;60(2):75\u201382.31902875"},{"issue":"8","key":"b15","series-title":"Neuro Oncol","first-page":"834","article-title":"ErbB\/HER receptor activation and preclinical efficacy of lapatinib in vestibular schwannoma","volume":"12","author":"Ammoun S","year":"2010","unstructured":"Ammoun S, Cunliffe CH, Allen JC,  ErbB\/HER receptor activation and preclinical efficacy of lapatinib in vestibular schwannoma. 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Lancet Respir Med. 2017;5(9):707\u2013716."},{"issue":"6","key":"b22","series-title":"Neurosurgery","first-page":"1314","article-title":"Three-dimensional volumetrics for tracking vestibular schwannoma growth in neurofibromatosis type II","volume":"62","author":"Harris GJ","year":"2008","unstructured":"Harris GJ, Plotkin SR, Maccollin M,  Three-dimensional volumetrics for tracking vestibular schwannoma growth in neurofibromatosis type II. Neurosurgery. 2008;62(6):1314\u20131320.18824998"},{"issue":"1","key":"b23","series-title":"J Neurooncol","first-page":"61","article-title":"Suggested response criteria for phase II antitumor drug studies for neurofibromatosis type 2 related vestibular schwannoma","volume":"93","author":"Plotkin SR","year":"2009","unstructured":"Plotkin SR, Halpin C, Blakeley JO,  Suggested response criteria for phase II antitumor drug studies for neurofibromatosis type 2 related vestibular schwannoma. J Neurooncol. 2009;93(1):61\u201377.19430883"},{"issue":"12","key":"b24","series-title":"Int J Audiol","first-page":"719","article-title":"Development and evaluation of Mandarin disyllabic materials for speech audiometry in China","volume":"46","author":"Wang S","year":"2007","unstructured":"Wang S, Mannell R, Newall P, Zhang H, Han D. Development and evaluation of Mandarin disyllabic materials for speech audiometry in China. Int J Audiol. 2007;46(12):719\u2013731.18049961"},{"issue":"21 suppl 1","key":"b25","series-title":"Neurology","first-page":"S25","article-title":"Hearing and facial function outcomes for neurofibromatosis 2 clinical trials","volume":"81","author":"Plotkin SR","year":"2013","unstructured":"Plotkin SR, Ardern-Holmes SL, Barker FG II,  Hearing and facial function outcomes for neurofibromatosis 2 clinical trials. 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Neuro Oncol. 2010;12(1):14\u201318.20150363"},{"issue":"2","key":"b28","series-title":"Brain Tumor Pathol","first-page":"62","article-title":"Bevacizumab for malignant gliomas: current indications, mechanisms of action and resistance, and markers of response","volume":"34","author":"Tamura R","year":"2017","unstructured":"Tamura R, Tanaka T, Miyake K, Yoshida K, Sasaki H. Bevacizumab for malignant gliomas: current indications, mechanisms of action and resistance, and markers of response. Brain Tumor Pathol. 2017;34(2):62\u201377.28386777"},{"issue":"5","key":"b29","series-title":"Ann Oncol","first-page":"807","article-title":"Management of hypertension in angiogenesis inhibitor-treated patients","volume":"20","author":"Izzedine H","year":"2009","unstructured":"Izzedine H, Ederhy S, Goldwasser F,  Management of hypertension in angiogenesis inhibitor-treated patients. 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Cancer Chemother Pharmacol. 2014;73(6):1197\u20131204.24710627"},{"issue":"2","key":"b32","series-title":"J Neuropathol Exp Neurol","first-page":"162","article-title":"Neuregulin growth factors and their ErbB receptors form a potential signaling network for schwannoma tumorigenesis","volume":"65","author":"Stonecypher MS","year":"2006","unstructured":"Stonecypher MS, Chaudhury AR, Byer SJ, Carroll SL. Neuregulin growth factors and their ErbB receptors form a potential signaling network for schwannoma tumorigenesis. J Neuropathol Exp Neurol. 2006;65(2):162\u2013175."},{"issue":"8","key":"b33","series-title":"Nat Clin Pract Oncol","first-page":"487","article-title":"Audiologic and radiographic response of NF2-related vestibular schwannoma to erlotinib therapy","volume":"5","author":"Plotkin SR","year":"2008","unstructured":"Plotkin SR, Singh MA, O\u2019Donnell CC, Harris GJ, McClatchey AI, Halpin C. 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