According to a new study published in the journal The Lancet Oncology, researchers have found that dacomitinib was not superior to erlotinib in patients with advanced non-small cell lung cancer (NSCLC) or in patients with KRAS wild-type tumors.
For the phase 3, randomized, multicenter, double-blind study, researchers enrolled 878 patients with locally advanced or metastatic NSCLC and randomly assigned them 1:1 to receive either dacomitinib or erlotinib. About half of patients from each group had KRAS wild-type tumors.
The researchers found a median progression-free survival of 2.6 months in both groups. Furthermore, in patients with wild-type KRAS tumors, median progression-free survival was 2.6 months for patients in the dacomitinib group and those in the erlotinib group, as well.The most frequent adverse effects observed in the dacomitinib group were diarrhea, rash, and stomatitis.
Dacomitinib is an irreversible epithelial growth factor receptor (EGFR) family tyrosine kinase inhibitor (TKI).
A previous phase 2 study demonstrate favorable efficacy for dacomitinib versus erlotinib for the treatment of patients with NSCLC; however, this study showed that further studies of dacomitinib should be limited to patients with activating EGFR mutations.
The authors aimed to compare dacomitinib with erlotinib in a phase 3 study. Irreversible EGFR inhibition with dacomitinib was not superior to erlotinib in an unselected patient population with advanced non–small–cell lung cancer or in patients with KRAS wild–type tumours. Further study of irreversible EGFR inhibitors should be restricted to patients with activating EGFR mutations.