Dacomitinib as a First-Line Therapy for Advanced EGFR-Mutated Non-Small Cell Lung Cancer Without Brain Metastases: A...

Area of Science:

• Oncology
• Pharmacology

Background:

• Limited real-world data on first-line dacomitinib for advanced EGFR-mutant NSCLC.
• Dacomitinib is an EGFR tyrosine kinase inhibitor.

Purpose of the Study:

• Evaluate clinical outcomes of first-line dacomitinib in advanced EGFR-mutant NSCLC without brain metastases.
• Assess objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and adverse events (AEs).

Main Methods:

• Retrospective cohort study of 161 patients with stage IIIB/IV EGFR-mutant NSCLC.
• Patients received first-line dacomitinib between October 2020 and August 2023.
• Outcomes included ORR, PFS, OS, predictive factors for PFS, and AEs.

Main Results:

• ORR was 64.0%, and disease control rate (DCR) was 91.3%.
• Median PFS was 20.93 months; median OS was 41.27 months.
• ECOG PS ≥2, bone, and liver metastases predicted shorter PFS. Secondary T790M mutation rate was 50.6% upon progression.

Conclusions:

• Dacomitinib is effective and well-tolerated for first-line treatment of advanced NSCLC with common EGFR mutations.
• Poor ECOG PS and bone/liver metastases are associated with worse PFS, indicating a need for alternative therapies in these subgroups.