Medical Information

Osimertinib can be taken for a long time under specific circumstances, but strict adherence to indications and tolerability assessments is required. The medication cycle ranges from 3 years of adjuvant therapy to continuous treatment for advanced patients, and needs to be dynamically adjusted based on disease progression, adverse reactions, and regular monitoring results.

1. Indications and medication cycle

(1) Adjuvant therapy: Patients with EGFR mutation positive non-small cell lung cancer after surgery need to take 80mg orally daily for 3 years or until recurrence.

(2) Late stage treatment: Patients with locally advanced or metastatic conditions need to continue medication until disease progression or intolerable toxicity occurs, with no fixed time limit.

2. Key points for evaluating long-term medication use

(1) Effectiveness monitoring: Regular imaging examinations are conducted to evaluate tumor progression, and stable patients can continue medication.

(2) Safety management: It is necessary to focus on monitoring interstitial lung disease, cardiac toxicity, and skin reactions. Adverse reactions of grade 3 or above should be temporarily or permanently discontinued.

3. Dose adjustment and special populations

(1) Adverse reaction management: If QT interval prolongation or congestive heart failure occurs, the medication should be reduced or stopped. If it does not improve within 3 weeks, the treatment should be terminated.

(2) Liver and kidney dysfunction: No adjustment is needed for mild to moderate cases, and there is no recommended dosage for patients with end-stage renal disease or severe liver damage.

4. Precautions

(1) Drug interactions: The combination of potent CYP3A inducers should be increased to 160mg/day, and the original dose should be restored after 3 weeks of discontinuation.

(2) Fertility risk: Strict contraception is required during treatment and 6 weeks (females)/4 months (males) after discontinuation of medication.

5. Core therapeutic advantages

(1) Targeted precision: Specifically inhibits EGFRDel19/L858R sensitive mutations and T790M resistant mutations, with minimal impact on wild-type EGFR.

(2) Strong penetrability: The blood-brain barrier has a high penetration rate, with a control rate of over 70% for brain metastases.

6. Special population effects

(1) Asian patients: The efficacy is better than non Asian populations, which may be related to differences in EGFR mutation rates.

(2) Elderly patients: Age does not affect drug efficacy, but cardiac toxicity monitoring needs to be strengthened.