Appearance of 4 Degree Rash While Treating Advanced Lung Cancer with Icotinib – Whether to Stop the Drug: A Case Report

Review Data

Q: Is the topic relevant to the journal area of interest? Is it contemporary and interesting for

researchers?

A: Excellent

Abstract & Keywords

Q: Are all required components included in the abstract? Are the keywords appropriately chosen?

A: Very good

Goal

Q: Is the goal explicitly stated in the Introduction? Is its formulation clear and unambiguous?

A: Very good

Structure

Q: Is the paper's structure coherent? Is it in coherence with the goal of the paper?

A: Very good

Tools and Methods

Q: Are methods the author uses adequate and well used?

A: Very good

Discussion & Conclusion

Q: Is it related to the results presented before? Do you consider them as coherent?

A: Very good

Comments:

The case description is adequate, and the Discussion covers the implications of the findings of the present case in necessary detail. The authors infer that icotinib can be used as a choice for the treatment of advanced non-small cell lung cancer, the rash may be a good prognostic sign, and the need to discontinue targeted therapy in case of severe adverse reactions need to be further explored.

Literature

Q: Does the author utilize relevant literature?

A: Good

Author's knowledge

Q: What is the level of the author’s knowledge? Does the author utilize all recent contributions relevant to the topic?

A: Good

Length

Q: Is the length of the paper adequate to the significance of the topic? Do you suggest shortening the paper without losing its value?

A: Good

Figures & Tables

Q: Does the author use them suitably? Are legend and notations clear?

A: Very good

Writing style

Q: Is it clear and understandable?

A: Weak

Comments: Several language issues were noted –

·       In the title, “appears” must be replaced with “appearance”, and “when” must be replaced with “while”.

·       Throughout the text, “appeared” must be replaced with “developed”.

·       Some sentences are incorrectly constructed, therefore making no sense –

§  the last sentence of the Abstract, “Thus, we would like to emphasize the importance that when patients occurred adverse reactions of 3-4 degree rash, whether need to stop drug” must be replaced with “Thus, we would like to emphasize the importance of deciding whether to stop the drug when patients developed adverse reactions of 3-4 degree rash”

§  the 3^rd sentence of the Introduction “In terms of efficacy, the efficacy of icotinib and gefitinib are equivalent but better security” must be replaced with “In terms of efficacy, icotinib and gefitinib are equivalent, but icotinib has a better security”

§  the 4^th sentence of the Introduction “Therefore, if the patients is EGFR mutation and elderly who can not tolerate chemotherapy, icotinib is more appropriate” must be replaced with “Therefore, for patients with EGFR mutation and the elderly who cannot tolerate chemotherapy, icotinib is more appropriate”

§  the 1^st sentence of the 1^st paragraph of the Case Report “The patient is a 75-years old male due to "recurrent cough, sputum for more than 30 years, and then increased with left chest pain more than 4 months" admitted” must be replaced with “The patient, a 75-year-old male with “recurrent cough, sputum for more than 30 years, and then increased with left chest pain more than 4 months” was admitted”

§  the 3^rd sentence of the 2^nd paragraph of Case Report “We recommend that patient stop taking icotinib, but who refused to do because of worrying about rapid recurrence and metastasis” must be replaced with “We recommended that patient stops taking icotinib, but he refused, worrying about rapid recurrence and metastasis”

§  the 2^nd sentence of the last paragraph of the Discussion “And that whether need to discontinue targeted therapy when severe adverse skin reactions occur, clinical workers need to be further explored” must be replaced with “Clinical workers need to further explore whether targeted therapy should be discontinued when severe adverse skin reactions occur”.

·       In the 3^rd sentence of the Abstract and the Significant finding of the study, “lead to” must be removed.

·       In What this study adds, “occurred” must be replaced with “developed”, and “there is a” must be inserted before “need”.

·       In the 1^st sentence of the Introduction, “generation of EGFR-TKI” must be replaced with “first-generation EGFR-TKI”, and “drugs” must be replaced with “drug”.

·       In the 3^rd sentence of the 1^st paragraph of Case Report, “an” must be replaced with “a”, and “which was cytology test” must be replaced with “the cytology test showed”.

·       In the 4^th sentence of the 1^st paragraph of Case Report, “to” must be removed.

·       In the 1^st sentence of the 2^nd paragraph of Case Report, “for” must be inserted before “7 days”, and “without” must be replaced with “he did not receive”.

·       In the last sentence of the last paragraph of Discussion, “to support” must be replaced with “for that”.

·       In the Funding, “Provence” must be replaced with “Province”.

Further comments on the paper

Comments: This is a report of a case of a 75-year-old man with advanced lung cancer who developed 4 degree rash as a severe adverse reaction to taking icotinib but refused to stop the drug; through anti-infection treatment and symptomatic nursing he recovered, the rash disappeared and he achieved a better prognosis. The report weighs in on the question of whether one needs to stop the drug in case of adverse reactions of 3-4 degree rash, although further clinical trials are a requisite. Also, the rash appeared and the severity of EGFR-TKIs seem to be clinically beneficial markers.

Q: Would you recommend this manuscript for further publication?

A: Yes - Suitable to be published

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Science Repository Team