Dr. Shum Discusses Dacomitinib in EGFR+ NSCLC

Elaine Shum, MD, medical oncologist, NYU Langone’s Perlmutter Cancer Center, discusses the use of dacomitinib (Vizimpro) in the treatment of patients with EGFR-positive non—small cell lung cancer (NSCLC).

The second-generation EGFR TKI had very impressive data in the ARCHER 1050 study, Shum says, but the toxicity profile of the drug may be reason for concern. With dacomitinib, there is much stronger toxicity than what is typically observed with this class of drugs, especially when compared with osimertinib (Tagrisso), the frontline standard of care. Shum notes that personally, she would not consider using dacomitinib in the frontline due to toxicity alone. However, as more is understood about sequencing EGFR TKIs, dacomitinib could have a potential role in later lines of therapy.

In September 2018, the FDA approved dacomitinib as a frontline treatment option for patients with metastatic NSCLC who harbor EGFR exon 19 deletion or exon 21 L858R substitution mutations. The approval was based on positive data from the phase III ARCHER 1050 trial, which showed a 40% reduction in the risk of disease progression or death compared with the first-generation EGFR TKI gefitinib (Iressa).