Lung cancer is increasingly treated with molecularly targeted agents, including EGFR inhibitors like Tagrisso®.  This EGFR targeted agent, also known as osimertinib, has been shown to prolong survival in advanced lung cancer (“NSCLC”) for an average of over three years, as reported by the FLAURA study, reported in NEJM in 2018.

FDA has approved Tagrisso in the setting of adjuvant (postoperative) treatment for lung cancer, treatment of lung cancer that has progressed after primary treatment, or initial treatment of lung cancer that harbors mutations in EGFR known as T790M or L858R.

EGFR-based treatment for lung cancer is a concept that emerged at least 15 years ago with the approval of Iressa in 2003 and then Tarceva in 2004 for EGFR-mutated lung cancer.

The EGFR is the Epidermal Growth Factor Receptor.  This receptor is thought to regulate the growth of epidermal cells. Usually this regulation is orderly and controlled. Due to environmental conditions such as tobacco smoke or other factors, the gene that encodes the EGFR protein can become mutated. Some of these mutations can disrupt the orderly regulation of cell growth, leading to cancer.

Medications like Iressa and Tarceva originally were designed to block the activation of the EGFR in the mutated state.  These drugs worked but they had many side effects and the cancer cell evolved ways of surviving despite treatment.

Tagrisso has been approved now for several years and works by overcoming the resistance caused by several specific DNA mutations in the EGFR gene.

Many patients wonder why treatment planning for lung cancer takes a long time.  In past years, doctors could order a biopsy and have a diagnosis within a day or so.  The only main question was whether the patient had a non-small cell lung cancer (NSCLC) or small cell lung cancer (SCLC).  Chemotherapy was the only treatment and the protocols were different depending on the type of cancer.

In the modern era, biopsy and conventional pathology reporting is not sufficient for lung cancer treatment planning. Oncologists need to know whether the patient has so-called “driver mutations” that follow set patterns.

In the case of Tagrisso, a specific mutation in EGFR is required to qualify for the medication. It only works in the proper setting.  Biopsy specimens must be sent to particular laboratories, often in different states, in order to move forward with treatment planning.

At Regatta Health, we have helped many patients access Tagrisso and other advanced targeted therapy for lung cancer, through our office dispensing program.  Many patients find it more convenient to pick up their medications in the office while they are visiting the doctor, rather than having to make phone calls to specialty pharmacies to arrange shipments and deliveries.  Patients enjoy being able to call us or come in to check on their medication directly with staff they know and trust. Regatta Health staff also have expertise on obtaining copay assistance from foundations and other organizations to help patients afford these costly medications.  Find out how we can help you access advanced medication at affordable prices for you or your loved one.  Call for an appointment with Dr. Benjamin or Dr. Melkonian today.