Exploration of the efficacy of dacomitinib/dacomitinib in the treatment of brain metastases from EGFR mutant non-small cell lung cancer

Dacomitinib/Dacomitinib (Dacomitinib), as a highly effective and irreversible pan-HER tyrosine kinase inhibitor (TKI), has been widely used in the treatment of epidermal growth factor receptor (EGFR) mutant non-small cell lung cancer (NSCLC). However, current research data are insufficient regarding its therapeutic effect in brain metastases.

In order to further explore the therapeutic effect of dacomitinib on brain metastases, a clinical study was also conducted, including non-small cell lung cancer patients with brain metastases confirmed by contrast-enhanced MRI and EGFR mutations confirmed by laboratory tests. A total of 14 eligible patients received first-line dacomitinib and were closely monitored with imaging and clinical monitoring. During the study, chest CT and brain MRI were used for regular efficacy evaluation. The first imaging examination was performed one month after treatment and was evaluated every two months thereafter. We determined the objective response rate (ORR) and the degree of response in brain metastases based on RECIST 1.1 and RANO-LM criteria.

In this study, a total of 59 patients with EGFR-mutated advanced non-small cell lung cancer received first-linedacomitinibtreatment, of which 14 patients had brain metastases before treatment. Depending on patient tolerance, some patients received 45 mg of dacomitinib daily, while others received 30 mg of dacomitinib daily. After a median follow-up of 4.5 months, we found that dacomitinib has a significant efficacy in brain metastases, with an effective rate of 92.9% and a disease control rate of 100%. Twelve of 14 patients experienced measurable responses in intracranial metastases, including 12 of 13 patients with parenchymal brain metastases. Of note, one patient with meningeal metastases did not respond well to treatment. Although all patients experienced grade 1-2 adverse reactions, none discontinued treatment or required dose adjustment due to adverse reactions.

This case series study of 14 patients preliminarily shows that dacomitinib shows effective efficacy in the treatment of brain metastases from EGFR-positive non-small cell lung cancer. However, in order to more comprehensively evaluate its efficacy and safety, and to optimize its clinical application strategy, more clinical data still need to be collected for in-depth analysis and research.