In a nutshell
This review aimed to assess the efficacy and safety of the new anticancer drug dacomitinib in comparison to current drug erlotinib. Both drugs are used to treat advanced non-small-cell lung cancer (NSCLC) with EGFR mutations. The study found that dacomitinib was marginally more effective than erlotinib in specific EGFR-mutant-NSCLC.
Some background
A mutation (change) in the epidermal growth factor receptor (EGFR) can lead to non-small cell lung cancer (NSCLC). EGFR-mutant-NSCLC has been shown to respond better to treatments that block EGFR, such as erlotinib (Tarceva). However, patients can develop resistance to current EGFR blocking drugs, so new drugs must be developed.
The most common EGFR mutations happen in gene locations known as exon 19 and exon 21. Mutations in these two locations are usually sensitive to EGFR blockers. Dacomitinib is an EGFR blocking drug that has undergone phase II and phase III clinical trials. It is not clear whether dacomitinib is more effective than erlotinib.
Methods & findings
This review pooled data from a phase 2 and a phase 3 trial to identify whether dacomitinib is more effective than erlotinib. The analysis inluded 100 patients with EGFR-mutant-NSCLC specific to exon 19 and exon 21. From these, 52 were treated with dacomitinib (group 1) and 48 patients were treated with erlotinib (group 2). Progression free survival (PFS, time to disease progression), overall survival (OS, time from beginning the trial to death from any cause), objective response rate (ORR, the number of patients whose tumors decreased by 50% or more) and adverse side effects were examined.
PFS was 14.6 months in group 1 compared to 9.6 months in group 2. The OS was 26.6 months in group 1 and 23.2 months in group 2. There was no difference in ORR.
Group 1 patients had a higher incidence of diarrhea, inflammation inside the mouth, nail infections, acne, rash and dry skin.
The bottom line
This review concluded that in terms of efficacy and safety, dacomitinib is comparable to erlotinib. Further trials will need to assess dacomitinib against other EGFR blocking drugs.
The fine print
This study was funded by Pfizer, the manufacturers of dacomitinib.
Published By :
Annals of oncology
Date :
Jan 13, 2016
