Are there any subsets of patients where you would consider first-line dacomitinib for EGFR mutations positive NSCLC?

I continue to favor osimertinib as front line therapy for patients with EGFR mutation positive NSCLC. A retrospective analysis of response and benefit of osimertinib in some less common EGFR mutations was published, including G719X, L861Q, and S768I. The analysis showed clinical benefit with osimertinib, supporting its use in some rare EGFR mutations. This data is lacking for dacomitinib.

Dacomitinib is a second-generation irreversible pan-human epidermal growth factor receptor (HER) family inhibitor approved for the first-line treatment of patients with metastatic NSCLC harboring EGFR Del19 or exon 21 L858R mutations. The randomized phase III ARCHER 1050 trial specifically excluded patients with atypical EGFR mutations. The trial demonstrat...