Osimertinib(泰瑞沙)奥希替尼的用法用量及剂量修改,Osimertinib(Osimertinib)推荐剂量为每日80mg，直至疾病进展或出现无法耐受的毒性。

Title: Usage, Dosage, and Dose Modifications of Osimertinib (Tagrisso) in the Treatment of Lung Cancer

Introduction:

Osimertinib (trade name Tagrisso) is a targeted therapy used in the treatment of non-small cell lung cancer (NSCLC). This article provides an overview of the usage, dosage, and dose modifications associated with osimertinib therapy.

1. Indications for Osimertinib:

Osimertinib is primarily prescribed for the treatment of advanced NSCLC with specific mutations in the epidermal growth factor receptor (EGFR) gene. The common EGFR mutations include exon 19 deletions and exon 21 L858R substitution mutations.

2. Recommended Dosage of Osimertinib:

The standard recommended dosage of osimertinib is 80 mg, taken orally once daily, with or without food. It is essential to follow the prescribed dosing schedule and not skip or alter doses without consulting a healthcare professional.

3. Dose Modifications:

Dose modifications of osimertinib may be necessary in certain circumstances, such as adverse reactions or concomitant use of certain medications. The following situations warrant dose adjustments:

a. Adverse Reactions: If a grade 3 or higher adverse reaction occurs (based on Common Terminology Criteria for Adverse Events - CTCAE), osimertinib administration should be interrupted until the adverse reaction improves to grade 1 or lower. Upon resolution, osimertinib therapy can be resumed at a reduced dose of 40 mg per day. If the adverse reaction reoccurs at the reduced dose, a further reduction to 20 mg per day may be considered.

b. Hepatic Impairment: For patients with moderate hepatic impairment (Child-Pugh Class B), the recommended dose of osimertinib is 40 mg once daily. There is limited data available for patients with severe hepatic impairment (Child-Pugh Class C), and osimertinib should be used with caution in such cases.

c. Concomitant Use of Strong CYP3A Inhibitors: If osimertinib is co-administered with strong cytochrome P450 3A (CYP3A) inhibitors (e.g., ketoconazole, clarithromycin), the recommended dose of osimertinib should be reduced to 40 mg once daily during co-administration. Once the strong CYP3A inhibitor is discontinued, the osimertinib dose can be increased to the standard 80 mg once daily after a washout period of 3-5 half-lives of the inhibitor.

4. Special Populations:

a. Elderly Patients: No specific dosage adjustment is required based solely on age. However, age-related factors and overall health condition should be taken into account when determining the appropriate dose of osimertinib for elderly patients.

b. Renal Impairment: Osimertinib does not require dose modification in patients with mild to moderate renal impairment (creatinine clearance ≥ 30 mL/min). Limited data are available for patients with severe renal impairment (creatinine clearance < 30 mL/min), and osimertinib should be used with caution in such cases.

In conclusion, osimertinib plays a crucial role in the treatment of advanced NSCLC with specific EGFR mutations. Following the recommended dosage, monitoring for adverse reactions, and making necessary dose modifications when indicated, ensure optimal treatment outcomes for patients receiving osimertinib therapy. It is important for healthcare professionals and patients to communicate effectively and collaborate to maintain treatment adherence and manage any potential concerns or complications that may arise during osimertinib therapy.