Uses

Indicated as first-line treatment for adult patients with metastatic non-small cell lung cancer (NSCLC) harbouring EGFR exon 19 deletion or exon 21 L858R substitution mutations as confirmed by an approved diagnostic test.

Do not use if

No contraindications are listed in the FDA label. Use with caution in patients with hepatic impairment.

Side effects

The most frequent adverse reactions (greater than 20%) include diarrhoea, rash, paronychia, stomatitis, decreased appetite, dry skin, and weight loss. Serious events include interstitial lung disease and severe dermatological reactions.

Warnings

Permanently discontinue if interstitial lung disease (ILD) or pneumonitis is confirmed. Withhold and dose-reduce for severe diarrhoea or dermatological toxicity. May cause foetal harm; effective contraception is required. Monitor for ocular toxicity.

How it works

Dacomitinib is a second-generation irreversible inhibitor of the pan-EGFR family (EGFR/HER1, HER2, and HER4) and selected EGFR-activating mutations. It covalently binds to the kinase domain ATP-binding site, permanently blocking downstream signalling that drives NSCLC tumour proliferation.

Storage

Store at 20–25°C (68–77°F); excursions permitted between 15–30°C (59–86°F). Store in original packaging.