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Q. My brother is on Tagrisso and has persistent vomiting while eating grains. Please help.

Answered by
Dr. Vikas T. Talreja
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on May 17, 2020

Hello doctor,

My brother os recently on Tagrisso. His recent scan is attached which shows improvement. He is vomiting while eating grains. What is the reason for vomiting and what can be done for this?

Please tell me about this response to Tagrisso. If it is good? How much time does Tagrisso take for the remission if it works like this? What is the average duration for Tagrisso to become resistant? Please clear my doubts.

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Hi,

Welcome to icliniq.com.

In reply to your question for Osimertinib (Tagrisso), Osimertinib demonstrated improvement in PFS (18.9 versus 10.2 months, HR 0.46, 95% CI 0.37-0.57) and duration of response (17.2 versus 8.5 months) relative to other TKI. The PFS (progression-free survival) benefit was consistent across subgroups, including either patient with or without brain metastases. Response rates for Osimertinib is around 80 %.

To put it to simple terms, the disease is controlled for more than 1.5 years with Osimertinib. Treatment with an EGFR TKI is generally continued until there is disease progression.

If there is persistent vomiting, we need to do more tests to confirm whether it is leptomeningeal (LM) disease which is diagnosed in approximately 5 percent of patients with metastatic cancer. The most common solid tumors giving rise to LM are breast cancer (12 to 35 percent), lung cancer (10 to 26 percent), melanoma (5 to 25 percent). Headache is the most common initial symptom of LM, present in 30 to 50 percent of patients with symptoms of confusion, forgetfulness, disorientation, subtle personality changes, and/or lethargy collectively referred to as encephalopathy or altered mental status, are common in patients with LM.

I would request to do Gadolinium-enhanced magnetic resonance imaging (MRI) of the brain and spine which often provides important evidence of LM. The definitive diagnostic finding for LM is the cytologic identification of malignant cells within the CSF (cerebrospinal fluid).


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