Dacomitinib shows promising real-world efficacy as first-line treatment for EGFR-mutant non-small cell lung cancer, demonstrating superior survival benefits over gefitinib.
Researchers have found compelling evidence supporting the use of dacomitinib, particularly for patients with specific mutations of non-small cell lung cancer (NSCLC), which is the most prevalent form of lung cancer and significantly impacts cancer survival rates globally.
With lung cancer remaining the leading cause of cancer-related deaths, targeted therapies have advanced over recent years, particularly for patients with actionable genetic alterations such as mutations of the Epidermal Growth Factor Receptor (EGFR). This retrospective study included 153 patients treated with dacomitinib between January 2021 and December 2022 at Samsung Medical Center and St. Vincent's Hospital, highlighting the drug’s efficacy and safety profile more broadly. Most patients had experienced significant mutations, and the study sought to evaluate actual clinical outcomes compared to those reported in controlled clinical trials.
The findings showed an objective response rate of 84.3% and highlighted the median progression-free survival (PFS) of 16.7 months. Crucially, the research indicated different success rates depending on the mutation type; patients with the exon 19 deletion had a median PFS of 18.1 months, whereas those with the L858R mutation had 15.9 months.
The study also explored the safety profile of dacomitinib, finding manageable adverse effects where about 94.1% of the patients reported at least one such event, most commonly rash and diarrhea. Notably, 85.6% of the patients needed dose reductions which are relatively commonplace, yet this study indicates the need for careful monitoring and adjustment of dosages among various demographics.
Another key finding was concerning the T790M mutation, which leads to resistance to treatment. The study reported this mutation present in 40.9% of patients who progressed after dacomitinib treatment, highlighting potential pathways for follow-up therapies.
Overall, the evidence from this study aligns with previous findings from the ARCHER 1050 clinical trial but also emphasizes the need for real-world validation of treatment approaches, especially among patients traditionally excluded due to complicate pathways such as brain metastases.
Given the study’s outcomes, dacomitinib presents itself as not just effective but necessary for consideration as part of standard therapy, particularly for the EGFR-mutant NSCLC population, and warrants attention for its place within broader treatment strategies.
Moving forward, the study advocates for additional research, particularly examining long-term outcomes and nuances tied to resistance mechanisms which will be pivotal for developing sustained treatment pathways for these patients.