OBJECTIVES : Dacomitinib is a human epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI). The direct comparison between Dacomitinib and Gefitinib as first-line treatments for EGFR mutation positive Non-Small Cell Lung Cancer (NSCLC) has been observed. This study was conducted to discover the efficacy of dacomitinib versus other relevant TKI comparators, which haven’t been reported before.

METHODS : Systematic review was conducted in the Embase, MEDLINE, and Cochrane Library. Searches were limited to articles between January 1, 2004 and December 1, 2019. Only data of Asian populations was included. Frequentist NMA was used. The results were presented as relative hazard ratios (HRs).

RESULTS : A total of 7 RCTs with 2126 patients were included. Dacomitinib had a consistent trend towards improved OS when compared with the other TKIs: afatinib (HR 0.80, 95% CrI 0.52-1.23), erlotinib (HR 0.82, 95% CrI 0.44-1.53), gefitinib (HR 0.76, 95% CrI 0.58-1.00), osimertinib (HR 0.76, 95% CrI 0.52-1.13), and icotinib (HR 0.64, 95% CrI 0.34-1.22); a statistically significantly improved PFS compared with erlotinib (HR 0.45, 95% CrI 0.22-0.90) and gefitinib (HR 0.51, 95% CrI 0.39-0.66); a trend towards improved PFS for afatinib (HR 0.67, 95% CrI 0.44-1.02), osimertinib (HR 0.93, 95% CrI 0.64-1.35) and icotinib (HR 0.59, 95% CrI 0.31-1.14).

CONCLUSIONS : Overall, this NMA found that dacomitinib had a consistent trend towards improved OS and PFS when compared with other TKIs for first-line treating locally advanced or metastatic EGFR mutation positive NSCLC among Asian populations.