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Osimertinib is an oral medication used in the treatment of non-small cell lung cancer (NSCLC), particularly in patients with specific genetic mutations. The brand name for osimertinib 80 mg is Tagrisso, which is manufactured by AstraZeneca. It is a third-generation, irreversible epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) designed to target EGFR mutations, including T790M, which is a common resistance mutation in patients who have previously received EGFR-targeted therapy.
Uses of Tagrisso (Osimertinib)
Tagrisso is primarily used in two key treatment settings:
First-Line Treatment for EGFR-Mutated NSCLC
It is approved as the first-line treatment for patients with metastatic EGFR exon 19 deletions or exon 21 L858R mutations.
Clinical trials, such as the FLAURA trial, have shown that Osimert-80mg-Osimertinib provides superior progression-free survival compared to earlier-generation EGFR inhibitors like erlotinib or gefitinib.
Treatment for EGFR T790M Mutation-Positive NSCLC
Patients who develop resistance to first- or second-generation EGFR inhibitors due to the T790M mutation can be treated with osimertinib.
The AURA3 trial demonstrated that Tagrisso significantly improved outcomes in this patient group.
Dosage and Administration
The standard recommended dose of Tagrisso is 80 mg once daily, with or without food.
It is available in tablet form and should be swallowed whole.
If a dose is missed, patients are advised not to take an extra dose but to continue with the next scheduled dose.
Mechanism of Action
Osimertinib works by irreversibly binding to the EGFR protein, inhibiting the growth of cancer cells that carry specific EGFR mutations. Unlike earlier TKIs, it has better penetration into the brain, making it effective against brain metastases, which are common in EGFR-mutated NSCLC.
Side Effects of Tagrisso
Common side effects include:
Diarrhea
Rash
Dry skin
Fatigue
Nail toxicity
Stomatitis (mouth sores)
Decreased appetite
Serious but rare side effects include:
Interstitial lung disease (ILD) or pneumonitis
QT prolongation, which can affect heart rhythm
Cardiomyopathy, leading to heart failure
Blood disorders, such as low white blood cell counts
Cost and Availability
Tagrisso is a high-cost medication, often exceeding $15,000 per month in the United States. Many patients rely on insurance coverage, patient assistance programs, or manufacturer discounts to afford treatment.
Conclusion
Osimertinib (Tagrisso) is a breakthrough treatment for EGFR-mutated NSCLC, offering better survival rates and fewer side effects compared to earlier-generation EGFR inhibitors. It has transformed the treatment landscape for lung cancer patients with EGFR mutations, providing a more effective and well-tolerated therapy option.
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