Retrospective real-world comparison of dacomitinib and afatinib for first-line treatment of EGFR-mutant advanced non-small cell lung cancer

The irreversible EGFR-TKIs afatinib and dacomitinib both are approved for first-line treatment of EGFR-mutant advanced non-small cell lung cancer (aNSCLC). A retrospective study at China Medical University Hospital in Taichung (Taiwan) compared efficacy and safety of both agents in this setting. Partial respons was seen in 85.7% of patients receiving afatinib and 80.6% of patients dacomitinib (p=0.522), while the median progression-free survival was 18.9 months versus 16.3 months (p=0.975) and time to treatment failure was 22.7 months versus 15.9 months (p=0,324). Frequency of diarrhea was higher with afatinib than with dacomitinib (75.8% versus 35.5%; p=0.001) while frequency of paronychia was higher with dacomitinib than with afatinib (58.1% versus 31.4%; p=0.004). There were no significant differences in frequency of other adverse events (rash, stomatitis, and pruritus). The authors conclude that afatinib and dacomitinib as first-line treatment for EGFR-mutant aNSCLC had similar activity and slightly different side effects.