New targeted therapies have potential to improve overall survival for patients with EGFR-mutation positive NSCLC

This study compared dacomitinib (PF-00299804) to gefitinib (Iressa) as a first treatment for patients with EGFR-mutation positive non-small-cell lung cancer. The authors concluded that treatment with dacomitinib provided an improved overall survival compared to gefitinib.

Current cancer therapy heavily relies on chemotherapy. As technology advances however, therapies are available to target specific types of cancers. Genetic mutations (changes) in a gene called EGFR can be involved in cancer. EGFR-TKIs such as gefitinib are anti-cancer drugs which work by specifically targeting this mutation. While the development of EGFR-TKIs has shown to be beneficial in increasing progression free survival (PFS, time from treatment until disease progression), overall survival (OS, time from treatment until death) has not seen a significant improvement. Therefore, newer EGFR-TKIs have been developed to improve this type of treatment, including dacomitinib.

This study compared the effectiveness of the newly developed drug dacomitinib to gefitinib. The trial included 452 patients with treatment naïve non-small-cell lung cancer (NSCLC). Patients were randomly assigned to one of two groups. 227 patients were treated with dacomitinib, while 225 patients were treated with gefitinib. The average follow up was 31.3 months.

By the final follow-up, 220 patients in total had died. Of these, 103 patients were treated with dacomitinib while 117 patients were treated with gefitinib.

OS was 24% longer for dacomitinib patients compared to gefitinib patients. Average OS was 34.1 months for dacomitinib patients and 26.8 months for gefitinib patients. This OS improvement was still present when ethnicity and type of mutation was accounted for.

Cancer spread to the brain in 1 dacomitinib patient and 11 gefitinib patients. 113 dacomitinib patients and 140 gefitinib patients went on to receive other treatments, such as chemotherapy.

The authors concluded that the new drug dacomitinib showed an improved OS compared to the current drug gefitinib for patients with NSCLC with EGFR-mutations.

This study received funding from the manufacturers of dacomitinib.