Is Osimertinib effective for my mother's lung cancer?

Hello,

Welcome to icliniq.com.

I understand your concern.

She is doing well, and I would keep her on Osimertinib 80mg daily. 17 months in with just some mild appetite loss and skin darkening, that is a light side effect profile. Stay on it as long as it is holding things back.

Scans every four to six months to keep tabs, and I would get an MRI of her brain every year to every year and a half. About half of epidermal growth factor receptor-mutant (EGFR) lung cancers eventually show up in the brain, so checking periodically makes sense.

These targeted drugs do stop working eventually. Osimertinib holds things for around 19 months on average. If she progresses, I would start with a liquid biopsy looking for new mutations like MET amplification or an ALK fusion. If that comes back negative, biopsy the growing tumor directly.

One or two spots of progression can often be handled with radiation without changing her systemic treatment. If it is spread wider, we would switch to Carboplatin and Pemetrexed (Alimta) for four to six cycles, then Pemetrexed maintenance. I usually pause the Osimertinib during the Carboplatin portion and bring it back when maintenance starts.

There are also newer agents coming, Patritumab Deruxtecan targeting HER3, and Amivantamab hitting both EGFR and MET. Not standard yet, but worth knowing about. Clinical trials are an option, too, and we can help sort out what fits wherever she's being treated. For now, she stays the course.

At present, continuation of the current treatment plan with regular monitoring is recommended.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.