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Dacomitinib as a First‐Line Therapy for Advanced EGFR‐Mutated Non‐Small Cell Lung Cancer Without Brain Metastases: A Multicenter Retrospective Observational Study

Title: Dacomitinib as a First‐Line Therapy for Advanced EGFR‐Mutated Non‐Small Cell Lung Cancer Without Brain Metastases: A Multicenter Retrospective Observational Study
Authors: Ping‐Chih Hsu; How‐Wen Ko; Li‐Chung Chiu; Shih‐Hao Huang; Chung‐Shu Lee; Yu‐Ching Lin; Scott Chih‐Hsi Kuo; Jia‐Shiuan Ju; Chin‐Chou Wang; Cheng‐Ta Yang
Source: Cancer Medicine, Vol 15, Iss 3, Pp n/a-n/a (2026)
Publisher Information: Wiley
Publication Year: 2026
Collection: Directory of Open Access Journals: DOAJ Articles
Subject Terms: common EGFR mutation; dacomitinib; epidermal growth factor receptor mutation; non‐small cell lung cancer (NSCLC); tyrosine kinase inhibitor; Neoplasms. Tumors. Oncology. Including cancer and carcinogens; RC254-282
Description: Background Real‐world evidence regarding the use of dacomitinib as a first‐line therapy for advanced non‐small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) mutations remains limited. This multicenter, retrospective cohort study aimed to evaluate the clinical outcomes of dacomitinib as a first‐line treatment in patients with untreated advanced EGFR‐mutant NSCLC without brain metastases. Patients and Methods This retrospective analysis included 161 patients with stage IIIB/IV EGFR‐mutant NSCLC without brain metastasis at baseline who received first‐line dacomitinib between October 2020 and August 2023 at four Taiwanese cancer centers. The primary outcomes included the objective response rate (ORR), progression‐free survival (PFS), overall survival (OS), predictive risk factors for PFS, and adverse events (AEs). Results The ORR was 64.0%, and the disease control rate (DCR) reached 91.3%. The median PFS was 20.93 months (95% CI: 17.55–24.32), and the median OS was 41.27 months (95% CI: 31.71–50.82). Multivariate analysis revealed that an Eastern Cooperative Oncology Group (ECOG) performance status (PS) ≥ 2, bone metastasis, and liver metastasis were independent predictors of shorter PFS. Among patients who experienced disease progression and underwent rebiopsy, the secondary T790M mutation rate was 50.6%. Most treatment‐related AEs were grade 1–2 and manageable. Conclusions Dacomitinib demonstrated favorable efficacy and tolerability as a first‐line therapy in advanced NSCLC patients with common EGFR mutations (exon 19 deletion or L858R). A baseline ECOG PS ≥ 2 and the presence of bone or liver metastases were significantly associated with worse PFS, suggesting a need for additional therapeutic strategies in these subgroups.
Document Type: article in journal/newspaper
Language: English
Relation: https://doi.org/10.1002/cam4.71659; https://doaj.org/toc/2045-7634; https://doaj.org/article/ec5b56f6c71241c19650fff6285c6607
DOI: 10.1002/cam4.71659
Availability: https://doi.org/10.1002/cam4.71659; https://doaj.org/article/ec5b56f6c71241c19650fff6285c6607
Accession Number: edsbas.BC84CB99
Database: BASE