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Jeffrey M. Clarke, MD, assistant professor of medicine, Duke Cancer Institute, compares EGFR TKIs in EGFR-positive non–small cell lung cancer.
Jeffrey M. Clarke, MD, assistant professor of medicine, Duke Cancer Institute, compares EGFR TKIs in EGFR-positive non—small cell lung cancer.
Both osimertinib (Tagrisso) and dacomitinib (Vizimpro) are FDA approved for the frontline treatment of this patient population, but osimertinib has emerged as the preferred agent in this setting. Clarke says that osimertinib, a third-generation EGFR TKI, has a longer median progression-free survival and a more favorable toxicity profile than dacomitinib, a second-generation irreversible pan-HER TKI.
Osimertinib appears to spare normal tissue better than other EGFR inhibitors, while dacomitinib is a potent drug, Clarke adds. Dacomitinib demonstrated an improvement in overall survival (OS) compared with gefitinib (Iressa) in the phase III ARCHER 1050 study. Researchers are still waiting for OS data with osimertinib, says Clarke. In terms of toxicity, osimertinib has lower rates of grade 3/4 adverse events with less incidence of rash and diarrhea.