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 -

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
Information type: Randomised controlled trials
Source: The Lancet Oncology
Specialities: Cancers | Respiratory disorders
Summary
This RCT (n=452) reports statistically significantly improved median progression-free survival of 14.7 months with dacomitinib, a second-generation, irreversible EGFR tyrosine kinase inhibitor (TKI) vs 9.2 months with gefitinib (HR 0.59, 95% CI 0.47–0.74; p<0.0001).
UKMi comment

In a related editorial, the author also describes separate data from the LUX-Lung 7 study (investigating afitinib), which, in addition to this ARCHER 1050 study, suggests second-generation TKIs are more effective, at least with respect to progression-free survival, than are first-generation TKIs. However, dose reductions were required in 66% of patients in the dacomitinib group in ARCHER-1050 and 42% in the afatinib group in LUX-Lung 7, vs 8% and 2% in the gefitinib groups in the two trials, respectively.

The author also describes the FLAURA3 trial, another phase III head-to-head trial of osimertinib against the first-generation TKIs erlotinib or gefitinib in treatment-naive patients which met its primary endpoint of progression-free survival (18.9 months for osimertinib vs 10.2 months for standard of care; HR 0.46, p<0.0001).
Related links: Editorial