Dacomitinib may be comparable to erlotinib in treating non-small cell lung cancer (NSCLC), specifically in patients that are positive for the epidermal growth factor receptor (EGFR) mutation.
Dacomitinib, an irreversible EGFR inhibitor, has already demonstrated efficacy in patients with EGFR mutation–positive NSCLC, but researchers sought to determine whether the drug—and those like it—is comparable to reversible EGFR inhibitors, such as erlotinib.
Researchers pooled patients from two separate clinical trials evaluating the effectiveness of erlotinib and dacomitinib in patients with advanced, EGFR mutation–positive NSCLC that had progressed after one or two chemotherapy regimens prior to taking either drugs. They then used the combined data to compare the efficacy of dacomitinib to erlotinib on the basis of progression-free survival, overall survival, and safety. Results were published in Annals of Oncology.
In total, researchers identified 121 patients with any EGFR mutation, the majority of whom (101 patients) had activating mutations in either exon 19 or exon 21, two fairly common EGFR mutation types. Of these 101 patients, median progression-free survival was 14.6 months among those who took dacomitinib and 9.6 months among those who took erlotinib. Further, findings showed that median overall survival was higher in those taking dacomitinib compared to erlotinib (26.6 months vs 23.2 months). However, in terms of safety, dacomitinib was shown to be associated with a greater incidence of negative side effects, particularly diarrhea and mucositis.
Therefore, researchers concluded that dacomitinib has comparable efficacy to erlotinib in patients with EGFR-mutated NSCLC. Treatment of those with specific mutations of exon 19 and 21 also showed particularly favorable outcomes with dacomitinib. An ongoing phase 3 trial will continue to test the effectiveness of dacomitinib compared with current first-line therapies for EGFR mutation–positive NSCLC.
Dacomitinib is produced by Pfizer and has not yet been approved for marketing by any regulatory agency.
