Dacomitinib for untreated EGFR mutation-positive non-small-cell lung cancer

1.1 Dacomitinib is recommended, within its marketing authorisation, as an option for untreated locally advanced or metastatic epidermal growth factor receptor (EGFR) mutation-positive non-small-cell lung cancer (NSCLC) in adults. It is recommended only if the company provides it according to the commercial arrangement.

Why the committee made these recommendations

Locally advanced or metastatic EGFR mutation-positive NSCLC is usually first treated with afatinib, erlotinib or gefitinib.

Evidence from a randomised controlled trial shows that people who take dacomitinib live longer than people who take gefitinib. They also live longer before their disease gets worse. An indirect comparison suggests there is no difference between dacomitinib and afatinib in terms of how long people live or how long it is before their disease gets worse.

There is some uncertainty about the assumptions used in the cost-effectiveness modelling. But the most plausible cost-effectiveness estimate is within what NICE normally considers an acceptable use of NHS resources. So dacomitinib is recommended.