Dr. Wakelee Discusses Dacomitinib in EGFR+ NSCLC

Heather Wakelee, MD, associate professor of medicine (oncology), Stanford University Medical Center, discusses dacomitinib in patients with EGFR-positive non—small cell lung cancer (NSCLC).

The data with dacomitinib have been very interesting, Wakelee says. In April 2018, the FDA granted dacomitinib a priority review for frontline treatment of patients with EGFR-positive locally advanced or metastatic NSCLC. This was based on findings from the phase III ARCHER 1050 trial, which compared dacomitinib with gefitinib (Iressa). Dacomitinib reduced the risk of disease progression or death by more than 40% and resulted in an average 6.5-month improvement in response duration compared with gefitinib as a first-line treatment.

Overall survival (OS) data were presented at the 2018 ASCO Annual Meeting. The median OS was 34.1 months in patients randomized to dacomitinib versus 26.8 months in those randomized to gefitinib. Wakelee says that challenges remain with toxicity. If this study had come out years ago before osimertinib (Tagrisso), then the question of whether to use dacomitinib in this population would not exist.