Can dacomitinib be used as third-line treatment?

Dacomitinib (Dacomitinib) is a first-line treatment for patients with non-small cell lung cancer carrying common epidermal growth factor receptor (EGFR) mutations; however, clinical evidence of its activity in NSCLC with complex EGFR mutations is limited. Advanced or metastatic non-small cell lung cancer is characterized by poor prognosis and infrequent second- or third-line treatment. First-generation reversible epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) paved the way for targeted therapy in lung cancer. These drugs have good efficacy in patients with activating EGFR mutations.

Existing data indicate that dacomitinib is effective in patients with non-small cell lung cancer, both as initial treatment and after failure of first-generation inhibitors. Additionally, preclinical data indicate that dacomitinib can achieve responses in tumors harboring the T790M (gatekeeper mutation), which is present in up to 50% of tumors that are resistant to first-generation inhibitors. Its effectiveness in potentially delaying the development of resistant clones and in combination with other targeting strategies is under investigation.

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).