Summary

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• Dacomitinib (Vizimpro) is indicated for the first-line treatment of patients with metastatic non-small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) exon 19 deletion or exon 21 L858R substitution mutations as detected by an FDA-approved test.
• A total of 7 studies from systematic reviews and meta-analyses were reviewed, focusing on the comparative effectiveness and safety of dacomitinib against other treatments.
• Several studies specifically analyzed Asian populations, highlighting variance in drug efficacy and safety among different ethnic groups. Specific subgroups included patients with EGFR exon 19 deletion (19del), EGFR L858R mutations, and those with brain metastases.
• In terms of progression-free survival (PFS), combinations involving erlotinib + bevacizumab or ramucirumab ranked highest in Asian populations. For overall survival (OS), top-ranking treatments included bevacizumab + chemotherapy, gefitinib + chemotherapy, and dacomitinib.
• Among patients with brain metastases, osimertinib combined with bevacizumab ranked highest for PFS. Dacomitinib showed better performance compared to standard care for patients without brain metastases but had a higher incidence of adverse events compared to newer generation TKIs like osimertinib.
• Combination therapies generally resulted in higher toxicity rates; however, specific case studies such as combining dacomitinib with olaparib provided notable benefits in resistant cases but also highlighted increased severe adverse events associated primarily when using combination treatments including gefitinib plus apatinib.