Dacomitinib is an active agent with comparable efficacy to erlotinib in patients with epidermal growth factor receptor (EGFR) mutation-positive advanced non-small cell lung cancer (NSCLC), particularly in those with exon 19 deletion, a study published online ahead of print in the journal Annals of Oncology has shown.1
Although the irreversible EGFR inhibitors, like dacomitinib, have demonstrated efficacy in patients with NSCLC with activating EGFR mutations, it is unclear whether they are superior to reversible inhibitors, like erlotinib. Therefore, researchers sought to conduct a pooled analysis of 2 randomized trials to compare the efficacy of dacomitinib with erlotinib.
For the study, researchers analyzed data from 129 patients with locally advanced/metastatic NSCLC and any EGFR mutation. Patients were only included if they had progressed on or after 1 or 2 chemotherapy regimens prior to dacomitinib or erlotinib. Of those, 101 had activating mutations in exon 19 or 21.
Results showed that among patients with exon 19 or 21 mutations, median progression-free survival was 14.6 months (95% CI, 9.0 – 18.2) with dacomitinib and 9.6 months (95% CI, 7.4 – 12.7) with erlotinib (HR, 0.717; 95% CI, 0.458 – 1.124; P = .146).
Researchers found that median overall survival was 26.6 months (95% CI, 21.6 – 41.5) with dacomitinib vs 23.2 months (95% CI, 16.0 – 31.8) with erlotinib (HR, 0.737; 95% CI, 0.431 – 1.259; P = .265).
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In terms of safety, dacomitinib was associated with a higher incidence of diarrhea and mucositis than with erlotinib in both studies.
The investigators noted that an ongoing phase 3 trial will compare dacomitinib with gefitinib in the first-line treatment setting of patients with NSCLC and common activating EGFR mutations.
- Ramalingam SS, O’Byrne K, Boyer M, et al. Dacomitinib versus erlotinib in patients with EGFR-mutated advanced nonsmall-cell lung cancer (NSCLC): pooled subset analyses from two randomized trials [published online ahead of print January 13, 2016]. Ann Oncol. doi: 10.1093/annonc/mdv593.