Osimertinib (Tagrisso®)
Osimertinib (brand name Tagrisso®) is a targeted therapy drug used to treat EGFR+ lung cancer.
Osimertinib may be given to people who have:
- stage 1b to 3a EGFR+ lung cancer and had surgery. In this instance, osimertinib is given after surgery to reduce the risk of the cancer coming back.
- advanced EGFR+ lung cancer (stage 4).
Targeted therapies like Osimertinib have been developed to interrupt the growth of lung cancers linked to some mutation types.
They are designed to block the processes that cause cancer to grow. The drug focuses on, or targets, the mutation (hence why it’s called targeted treatment).
These drugs are also sometimes called biological therapies.
How is osimertinib taken?
Osimertinib come as a tablet which you take by mouth every day at home. You do not need to go to hospital to receive this treatment.
You can take osimertinib with or without food. It is recommended that you take your tablets at the same time each day.
If you forget to take your tablets, do not take an extra dose. If there is more than 12 hours until you are due your next dose, take your tablets as soon as you remember. If you have any concerns about your dose, contact your lung cancer team.
Within a few weeks of taking osimertinib, people can often feel better as their symptoms from the cancer reduce. People may notice reduced coughing, easier breathing and reduced pain.
You will usually keep taking osimertinib for as long as you are getting benefit from it. For some people, this may only be for a few months, but for others, they may be on these treatments for several years.
If it looks like your cancer is starting to grow again, your cancer team may suggest a change in your treatment.
Throughout your treatment, you will have regular consultations with your lung cancer team to check how you are responding to treatment and how you are managing any side effects.
The benefits of osimertinib
As with all cancer treatments, people respond differently to treatment. For some people receiving osimertinib, the potential benefits can:
- cause the cancer to shrink more than chemotherapy
- cause fewer side effects than other treatments and therefore support a better quality of life
- increase life expectancy over chemotherapy.
STORY
Potential side effects of osimertinib
People taking osimertinib can experience many different side effects, especially when they first start taking the drug.
Common side effects can include:
- Diarrhoea
- Nail infections (paronychia)
- Feeling nauseous or being sick
- Rash or other skin problems
- Sore mouth or mouth ulcers
- Hair thinning.
Practical advice to reduce side effects
Diarrhoea
- Take small sips of liquids (such as sports drinks without sugar) often throughout the day.
- Eat mild food, such as toast and crackers.
- Limit spicy foods.
- There are also anti diarrhoea medications which can help reduce diarrhoea in most people.
Nail infections
- Keep your hands as warm and dry as possible.
- Avoid manicures and nail treatments (including varnish and artificial nails), exposing the hands to irritating substances, or wetting and washing them frequently.
- Wear gloves for any tasks that involve water, irritants, and chemicals, such as food preparation, washing up, cleaning and using hair dyes.
- Keep your nails trimmed and short, using nail clippers. Avoid biting your nails, trimming or pushing back the nail cuticles.
- Your doctor may prescribe treatments such as corticosteroid or antibacterial/antifungal cream, tacrolimus ointment or antibiotic or antifungal tablets.
Feeling nauseous or being sick
- Identify the type of food that may make you feel worse.
- Drink plenty of fluids.
- There are also anti sickness drugs which can help reduce nausea in most people.
Rash or other skin problems
- Moisturise your skin regularly. Your lung cancer nurse or cancer team will advise which creams are best.
- Avoid being out in hot sun.
- Use a sunscreen of SPF 30 or higher, preferably containing zinc oxide or titanium dioxide.
- Wear a hat in the sun.
- Avoid over-the-counter spot-related treatments, including products with benzoyl peroxide.
- Remove any dermatologist-approved makeup with a gentle liquid cleanser.
- Ask your GP for creams or steroids that may help
You should always tell your lung cancer nurse if you are experiencing any side effects from osimertinib as they may be able to help minimise them.
Jules’s story
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Jules has experienced many different side effects since taking osimertinib, including mouth ulcers and nail infections.
“When I notice possible side effects, I try not to panic and consult my medical team straightaway.”
Severe side effects
If you have any of the following side effects, you need to contact your lung cancer team as soon as possible:
- Breathing difficulties, shortness of breath or worsening breathing problems
- A cough
- A high temperature (37.5C or higher)
- Slow pulse (50 beats per minute or less), feeling tired, dizzy or faint, or losing consciousness
- Pain in your abdominal (belly), chest and/or back pain
- Itching
- Yellowing of the skin and eyes
- Changes in mental processes such as confusion, memory loss, and reduced ability to concentrate
- Changes in mood including irritability and mood swings
- Changes in speech including difficulty speaking, such as slurred or slow speech.
Work and osimertinib
Continuing to work while receiving osimertinib is an option as your treatment is in tablet form that you take at home.
Whether you are able to continue to work, or return to work, will depend on your personal situation and how your physical and mental wellbeing are affected by your treatment.
Some people decide to keep their cancer diagnosis private because that’s their nature, others because they want to avoid any potential negative reactions from their employer or colleagues.
By law, you don’t need to tell your employer about having lung cancer though it may be more practical for you to do so. Your employer may be able to support you and take your condition into consideration.
What happens if osimertinib stops working
Over time, cancer cells can develop a resistance to osimertinib. When this happens, the cancer can start to grow again. This doesn’t automatically mean that your treatment will be stopped.
If you have an isolated recurrence of your lung cancer, you may be offered surgery or radiotherapy to treat it whilst remaining on osimertinib.
However, if your cancer continues develops resistance and grow, your cancer doctor may decide to stop your treatment. Should this happen, your doctor will talk to about the other treatments that may be available to you.
Karen’s story
Karen was on osimertinib for about nine months when she first had progression. She stayed on the drug for a few more months as well as joining a clinical trial for stereotactic radiotherapy.
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Unfortunately, Karen’s cancer continued to grow, and she had to stop taking osimertinib. Karen was then offered chemotherapy, which she tolerated better than she expected.
Read Karen’s story >>
Support for people taking osimertinib
We offer support to people with EGFR+ lung cancer.
- Download the Mutation drive lung cancer and its treatment booklet
- Speak to our helpline nurses
- Register for one of our online support sessions
- Join our online forum.