Which is better, dacomitinib or osimertinib?

Dacomitinib and Osimertinib are two targeted therapies used in the treatment of non-small cell lung cancer (NSCLC). They are all tyrosine kinase inhibitors and are targeted at patients with positive EGFR gene mutations. While both drugs have shown some efficacy in treating the same type of lung cancer, they differ in some ways.

Despite the clinical success of the third-generation EGFR inhibitor osimertinib as a first-line treatment for EGFR-mutated non-small cell lung cancer, drug resistance has emerged due to the acquisition of EGFR second-site mutations and other mechanisms, which requires alternative therapies. The pan-HER inhibitor dacomitinib, approved for first-line treatment, causes acquired EGFR mutations that are different from those that mediate targeted resistance to osimertinib. Therefore, the combination of osimertinib and dacomitinib may induce a more durable response by preventing the emergence of resistance. Osimertinib has shown better tolerability and fewer adverse effects in some clinical trials, particularly with a lower risk of cardiotoxicity. Dacomitinib may cause some common adverse reactions, such as diarrhea, rash, etc.

The original drug of dacomitinib has been launched in China and has entered the scope of Class B medical insurance. The price of the common specification 15mg*30 tablets per box may be more than 1,000 yuan; the European version of dacomitiniboriginal drug sold overseas, the specification 45mg*30 tablets may be more than 20,000 yuan per box (the price may fluctuate due to exchange rates). Currently, there are cheaper generic drugs of dacomitinib sold overseas. Their pharmaceutical ingredients are basically the same as those of the original drugs sold domestically and abroad. For example, the price of 45mg*30 tablets produced by a Lao pharmaceutical factory may be around a few hundred yuan per box (the price may fluctuate due to exchange rate effects).