What should you pay attention to when taking dacomitinib/dacomitinib (Dozerun)?

Dacomitinib/Dacomitinib (Dacomitinib) is a targeted drug used to treat non-small cell lung cancer , mainly targeting patients with EGFR mutations. Despite its remarkable efficacy, some serious side effects and precautions have been exposed in clinical studies, especially interstitial lung disease, diarrhea, adverse skin reactions, and embryo-fetal toxicity. Based on these potential risks, doctors need to promptly adjust the dosage of dacomitinib according to changes in the patient's condition, including reduction, temporary discontinuation, or permanent discontinuation.

1. Interstitial lung disease (ILD) and pneumonia are one of the most concerning risks when using dacomitinib. There is a risk of severe and fatal interstitial lung disease (ILD) or pneumonia in patients treated with dacomitinib. Such patients usually experience respiratory symptoms such as difficulty breathing, cough, and fever. Once these symptoms occur, doctors should immediately stop dacomitinib and initiate further examinations to rule out or confirm the occurrence of ILD. If interstitial lung disease is confirmed, dacomitinib will need to be permanently discontinued. Although this reaction is rare, once it occurs, it is often one of the most urgent complications during treatment. Therefore, monitoring of pulmonary symptoms must be strengthened during treatment, especially for patients with underlying lung diseases.

2. Diarrhea is also one of the common side effects of dacomitinib. Clinical studies have shown that severe and fatal diarrhea may affect the safety of dacomitinib treatment, especially when diarrhea reaches grade 2 or higher, and the drug must be discontinued and treated. Specifically, once the severity of diarrhea reaches grade 2 or above, doctors will recommend discontinuing dacomitinib until diarrhea symptoms return to grade 1 or below. When resuming use, the dose needs to be adjusted based on the severity of diarrhea, either by returning to the original dose or by reducing the dose. In addition, anti-diarrheal treatment, such as loperamide or diphenoxy hydrochloride plus atropine sulfate, should be carried out promptly during dacomitinib treatment to reduce diarrhea symptoms.

3. Adverse skin reactions, especially rash and skin exfoliation reactions, are also side effects that require special attention when using dacomitinib. In clinical studies, the incidence of skin adverse reactions is relatively high, and patients may experience varying degrees of symptoms such as rash, erythema, or skin peeling. For skin reactions grade 2 or above, doctors will suspend the use of dacomitinib until symptoms return to grade 1 or below. When medication is resumed, the dose will be adjusted based on the patient's skin reaction. It is important to note that sun exposure may exacerbate adverse skin reactions, so patients are advised to take steps to limit sun exposure during treatment and to use moisturizer and appropriate sun protection. During the treatment process, if a mild rash occurs, the patient can use topical antibiotics or topical steroids for treatment; if the rash symptoms are more severe, oral antibiotics are required.

4. Dacomitinib exists in the embryo-Risk of fetal toxicity. In animal studies, oral administration of dacomitinib to pregnant rats resulted in increased rates of postimplantation loss and reduced fetal weight, particularly during organogenesis. Therefore, dacomitinib may have adverse effects on the fetus when used in pregnant women, leading to embryonic or postpartum death. This risk suggests that pregnant women should avoid using dacomitinib during treatment. For women of childbearing potential, it is recommended to use effective contraceptive measures during dacomitinib treatment and within 17 days after the end of treatment to ensure the avoidance of unwanted pregnancy.

Reference materials:https://www.pfizer.com/products/product-detail/vizimpro