We use cookies to improve your experience. By continuing to browse this site, you accept our cookie policy.×
Skip main navigation
Aging Health
Bioelectronics in Medicine
Biomarkers in Medicine
Breast Cancer Management
CNS Oncology
Colorectal Cancer
Concussion
Epigenomics
Future Cardiology
Future Medicine AI
Future Microbiology
Future Neurology
Future Oncology
Future Rare Diseases
Future Virology
Hepatic Oncology
HIV Therapy
Immunotherapy
International Journal of Endocrine Oncology
International Journal of Hematologic Oncology
Journal of 3D Printing in Medicine
Lung Cancer Management
Melanoma Management
Nanomedicine
Neurodegenerative Disease Management
Pain Management
Pediatric Health
Personalized Medicine
Pharmacogenomics
Regenerative Medicine

Dacomitinib in non-small-cell lung cancer: a comprehensive review for clinical application

    Hao Sun

    Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital, First Affiliated Hospital of South China University of Technology, Guangzhou 510080, PR China

    &
    Yi-Long Wu

    *Author for correspondence:

    E-mail Address: syylwu@live.cn

    Guangdong Lung Cancer Institute, Guangdong Provincial People’s Hospital & Guangdong Academy of Medical Sciences, Guangzhou 510080, PR China

    Published Online:https://doi.org/10.2217/fon-2018-0535

    Dacomitinib is a second-generation EGFR tyrosine kinase inhibitor (TKI) that irreversibly binds to and inhibits EGFR/Her1, Her2 and Her4 subtypes with an efficacy comparable to other TKIs. In the ARCHER 1050 trial, progression-free survival was improved by dacomitinib compared with gefitinib, supporting dacomitinib as a first-line treatment option for advanced non-small-cell lung cancer with sensitive EGFR mutation. Regarding to the higher adverse events rate, dose reductions did not reduce the efficacy of dacomitinib and could effectively decreased the incidence and severity of adverse events. Considering the evolving landscape of EGFR-mutant non-small-cell lung cancer, future head to head comparison between dacomitinib and osimertinib could provide key information to determine the optimal TKI treatment schedule.

    Papers of special note have been highlighted as: • of interest; •• of considerable interest

    References

    • 1. Lynch TJ , Bell DW , Sordella R et al. Activating mutations in the epidermal growth factor receptor underlying responsiveness of non-small-cell lung cancer to gefitinib. N. Engl. J. Med. 350(21), 2129–2139 (2004).
    • 2. Paez JG , Jänne PA , Lee JC et al. EGFR mutations in lung cancer: correlation with clinical response to gefitinib therapy. Science 304(5676), 1497–1500 (2004).
    • 3. Rosell R , Carcereny E , Gervais R et al. Erlotinib versus standard chemotherapy as first-line treatment for European patients with advanced EGFR mutation-positive non-small-cell lung cancer (EURTAC): a multicentre, open-label, randomised Phase 3 trial. Lancet Oncol. 13(3), 239–246 (2012).
    • 4. Zhou C , Wu Y-L , Chen G et al. Erlotinib versus chemotherapy as first-line treatment for patients with advanced EGFR mutation-positive non-small-cell lung cancer (OPTIMAL, CTONG-0802): a multicentre, open-label, randomised, Phase 3 study. Lancet Oncol. 12(8), 735–742 (2011).
    • 5. Maemondo M , Inoue A , Kobayashi K et al. Gefitinib or chemotherapy for non-small-cell lung cancer with mutated EGFR. N Engl J Med. 362(25), 2380–2388 (2010).
    • 6. Mok TS , Wu Y-L , Thongprasert S et al. Gefitinib or carboplatin–paclitaxel in pulmonary adenocarcinoma. N. Engl. J. Med. 361(10), 947–957 (2009).
    • 7. Gonzales AJ , Hook KE , Althaus IW et al. Antitumor activity and pharmacokinetic properties of PF-00299804, a second-generation irreversible pan-erbB receptor tyrosine kinase inhibitor. Mol. Cancer Ther. 7(7), 1880–1889 (2008).
    • 8. Engelman JA , Zejnullahu K , Gale C-M et al. PF00299804, an irreversible pan-ERBB inhibitor, is effective in lung cancer models with EGFR and ERBB2 mutations that are resistant to gefitinib. Cancer Res. 67(24), 11924–11932 (2007).
    • 9. Wu YL , Cheng Y , Zhou X et al. Dacomitinib versus gefitinib as first-line treatment for patients with EGFR-mutation-positive non-small-cell lung cancer (ARCHER 1050): a randomised, open-label, Phase 3 trial. Lancet Oncol. 18(11), 1454–1466 (2017). •• An important study demonstrates that dacomitinib is superior to gefitinib respect to progression-free survival and response rate in the first-line therapy of EGFR mutation non-small-cell lung cancer (NSCLC).
    • 10. Mok TS , Cheng Y , Zhou X et al. Improvement in overall survival in a randomized study that compared dacomitinib with gefitinib in patients with advanced non-small-cell lung cancer and EGFR-activating mutations. J. Clin. Oncol. 36(22), 2244–2250 (2018). •• The Following analysis of ARCHER 1050 which demonstrate dacomitinib can bring a longer overal survival than gefitinib as first-line therapy for EGFR mutation NSCLC.
    • 11. Wang SE , Narasanna A , Perez-Torres M et al. HER2 kinase domain mutation results in constitutive phosphorylation and activation of HER2 and EGFR and resistance to EGFR tyrosine kinase inhibitors. Cancer Cell. 10(1), 25–38 (2006).
    • 12. Cappuzzo F , Ligorio C , Jänne PA et al. Prospective study of gefitinib in epidermal growth factor receptor fluorescence in situ hybridization-positive/phospho-Akt-positive or never smoker patients with advanced non-small-cell lung cancer: the ONCOBELL trial. J. Clin. Oncol. 25(16), 2248–2255 (2007).
    • 13. Zahonero C , Aguilera P , Ramírez-Castillejo C et al. Preclinical test of dacomitinib, an irreversible EGFR inhibitor, confirms its effectiveness for glioblastoma. Mol. Cancer Ther. 14(7), 1548–1558 (2015).
    • 14. Zugazagoitia J , Díaz A , Jimenez E et al. Second-line treatment of non-small cell lung cancer: focus on the clinical development of dacomitinib. Front. Med. 4(8), 947–945 (2017).
    • 15. Ramalingam SS , Janne PA , Mok T et al. Dacomitinib versus erlotinib in patients with advanced-stage, previously treated non-small-cell lung cancer (ARCHER 1009): a randomised, double-blind, Phase 3 trial. Lancet Oncol. 15(12), 1369–1378 (2014).
    • 16. Ellis PM , Shepherd FA , Millward M et al. Dacomitinib compared with placebo in pretreated patients with advanced or metastatic non-small-cell lung cancer (NCIC CTG BR.26): a double-blind, randomised, Phase 3 trial. Lancet Oncol. 15(12), 1379–1388 (2014).
    • 17. Arcila ME , Chaft JE , Nafa K et al. Prevalence, clinicopathologic associations, and molecular spectrum of ERBB2 (HER2) tyrosine kinase mutations in lung adenocarcinomas. Clin. Cancer Res. 18(18), 4910–4918 (2012).
    • 18. Takezawa K , Pirazzoli V , Arcila ME et al. HER2 amplification: a potential mechanism of acquired resistance to EGFR inhibition in EGFR-mutant lung cancers that lack the second-site EGFRT790M mutation. Cancer Discov. 2(10), 922–933 (2012).
    • 19. Kris MG , Camidge DR , Giaccone G et al. Targeting HER2 aberrations as actionable drivers in lung cancers: Phase II trial of the pan-HER tyrosine kinase inhibitor dacomitinib in patients with HER2-mutant or amplified tumors. Ann. Oncol. 26(7), 1421–1427 (2015).
    • 20. Jänne PA , Boss DS , Camidge DR et al. Phase I dose-escalation study of the pan-HER inhibitor, PF299804, in patients with advanced malignant solid tumors. Clin. Cancer Res. 17(5), 1131–1139 (2011).
    • 21. Janne PA , Ou SH , Kim DW et al. Dacomitinib as first-line treatment in patients with clinically or molecularly selected advanced non-small-cell lung cancer: a multicentre, open-label, Phase 2 trial. Lancet Oncol. 15(13), 1433–1441 (2014). • This single-arm ARCHER 1017 trial first supported that dacomitinib can bring a promising progression-free survival (18.2 months) for untreated NSCLC harboring EGFR-mutant non-small-lung cancer.
    • 22. Chen Y , Wang M , Zhong W , Zhao J . Pharmacokinetic and pharmacodynamic study of Gefitinib in a mouse model of non-small-cell lung carcinoma with brain metastasis. Lung Cancer. 82(2), 313–318 (2013).
    • 23. McGranahan T , Nagpal S . A neuro-oncologist's perspective on management of brain metastases in patients with EGFR mutant non-small cell lung cancer. Curr. Treat. Options in Oncol. 18(4), 22 (2017).
    • 24. Kelly WJ , Shah NJ , Subramaniam DS . Management of brain metastases in epidermal growth factor receptor mutant non-small-cell lung cancer. Front. Oncol. 8, 59950 (2018).
    • 25. Piotrowska Z , Gainor JF . ARCHER 1050: hitting an important mark in EGFR-mutant lung cancer? J. Clin. Oncol. 36(22), 2241–2243 (2018).
    • 26. Sequist LV , Yang JC , Yamamoto N et al. Phase III study of afatinib or cisplatin plus pemetrexed in patients with metastatic lung adenocarcinoma with EGFR mutations. J. Clin. Oncol. 31(27), 3327–3334 (2013).
    • 27. Reckamp KL , Giaccone G , Camidge DR et al. A Phase 2 trial of dacomitinib (PF-00299804), an oral, irreversible pan-HER (human epidermal growth factor receptor) inhibitor, in patients with advanced non-small cell lung cancer after failure of prior chemotherapy and erlotinib. Cancer 120(8), 1145–1154 (2014).
    • 28. Lacouture ME , Keefe DM , Sonis S et al. A Phase II study (ARCHER 1042) to evaluate prophylactic treatment of dacomitinib-induced dermatologic and gastrointestinal adverse events in advanced non-small-cell lung cancer. Ann. Oncol. 27(9), 1712–1718 (2016).
    • 29. Mok T , Nakagawa K , Rosell R et al. Effects of dose modifications on the safety and efficacy of dacomitinib for EGFR mutation-positive NSCLC. J. Thorac. Oncol. 13(10), S454 (2018).
    • 30. Wong HH , Halford S . Dose-limiting toxicity and maximum tolerated dose: still fit for purpose? Lancet Oncol. 16(13), 1287–1288 (2015).
    • 31. Jain RK , Lee JJ , Hong D et al. Phase I oncology studies: evidence that in the era of targeted therapies patients on lower doses do not fare worse. Clinical Cancer Research. 16(4), 1289–1297 (2010).
    • 32. Goulart BHL , Clark JW , Pien HH , Roberts TG , Finkelstein SN , Chabner BA . Trends in the use and role of biomarkers in Phase I oncology trials. Clinical Cancer Research. 13(22 Pt 1), 6719–6726 (2007).
    • 33. Van Cutsem E , Tejpar S , Vanbeckevoort D et al. Intrapatient cetuximab dose escalation in metastatic colorectal cancer according to the grade of early skin reactions: the randomized EVEREST study. J. Clin. Oncol. 30(23), 2861–2868 (2012).
    • 34. Soria JC , Ohe Y , Vansteenkiste J et al. Osimertinib in untreated EGFR-mutated advanced non-small-cell lung cancer. N. Engl. J. Med. 378(2), 113–125 (2018). •• An important clinical trial which indicated that osimertinib is superior to first-generation TKI (gefitinib) regarding to PFS.
    • 35. Park K , Tan E-H , O'Byrne K et al. Afatinib versus gefitinib as first-line treatment of patients with EGFR mutation-positive non-small-cell lung cancer (LUX-Lung 7): a Phase 2B, open-label, randomised controlled trial. Lancet Oncol. 17(5), 577–589 (2016). • A study compared the efficacy of afatinib and gefitinib as first-line treatment for advanced NSCLC