NSCLC with pleural metastases: Anyone on osimertnib?

Hello @saurabh, welcome to Mayo Connect. These decisions are always difficult, especially when you have differing opinions. Mayo Connect includes patients and family members, we are not doctors and cannot provide medical advice. We can discuss our own situations.
There many lung cancer survivors taking targeted therapy medications (TKI). I have a different mutation, so I take a different TKI, Alectinib for ALK positive lung cancer, stage IV. These medications target the cancer at the cellular level and have proven to be very effective when we can tolerate them. I never took chemotherapy, I went on the Alectinib and it cleared all of my tumors.
Not everyone can tolerate these medications, especially along with chemo. How are you/your loved one tolerating the chemo? Have the doctors presented the reasoning behind their recommendations?

hi @saurabh - if the oncologists you have met with disagree, my advice would be to seek an opinion from the best cancer center you can access. in the US those places will have a Tumor Board (group of doctors treating lung cancer with differing expertise - ie: surgeon, radiologist, radiation oncologist, medical oncologist) meet and give you an institutional opinion on what the best treatment plan would be.

have you (or the patient) had biomarker testing completed? that is important in identifying which treatments would be most helpful.

in the meantime, you can read the FLAURA2 clinical trial that showed chemo (cisplatin or carboplatin) + permextred + osimertinib had better outcomes than just osimertinib in patients with locally advanced or metastatic non small cell lung cancer.
https://www.nejm.org/doi/full/10.1056/NEJMoa2306434

My mother has lung carcinoma with parietal pleural deposits on the and doctor has advised Osimertinib 80 mg, does anyone have any experience with this targeted medicine and would like to share his or her experience with me.
1. Can it cure the patient who is in stage 4a.
2. For how long can one take this medicine.
3. Has anyone used a generic version of this medicine is it recommended.
4. What are the side effects one can face using it.
Please feel free to share you experience ang knowledge.
Regards Saurabh

@saurabh - I'm sorry to hear your mother has lung cancer. the brand name for osimertinib is Tagrisso - you can find lots of threads/comments on Mayo Connect about peoples' experiences with it. Tagrisso has been approved for use here in the US since 2016, but there is no generic available here. I've seen references to patients who have taken it for many years. that said, how long it can be used, depends on the type of lung cancer and the overall health of the patient. when osimertinib is used as a second or third line treatment, patients eventually develop resistance. has your mother had biomarker testing of her cancer completed? osimertinib works best on EGFR mutated non small cell lung cancer.

the main side effects are usually: diarrhea, skin rash/very dry skin, weak nails, fatigue. I also had hair loss and an increased heart rate. some people have joint pain.

Hi. I’ve been on Tagrisso since late February for stage 4 adenocarcinoma of the lung. I was dx’d with EGFR L858R Exon 21. There are other variations of EGFR. Without Tagrisso I had a poor prognosis. So I take it every day. I’ve had very few side effects, initially a face rash and cuts on fingers by the nails. If your mom gets a side effect she should check with oncology as there is typically something that can help. I’ve read of people who were on it for years. Personally, I’m very grateful for this medication which has shrunk my tumors! It’s not a cure but a treatment.

Hello @saurabh, I'm glad to read that your mother will start the targeted therapy, Tagrisso/osimertinib. These types of medications have been game-changers in extending the lives of lung cancer patients. I take a different targeted therapy for a different type of mutation (ALK, alectinib, 6 years), and I believe that I wouldn't be here today without these medications. These drugs don't cure the cancer, but they can be very effective for years at a time for the fortunate patients. Were her doctors hopeful? Did they provide answers to your questions? Is she taking the osimertinib along with chemotherapy, or did they stop the chemo? How are YOU doing through this period of diagnosis and early treatment? It's not an easy path.

@lls8000 I am 81 and was diagnosed with non small cell lung cancer with Mets to the brain and EGFR - June of 2024, had 4 rounds of chemo, brain radiation and Tagrisso on July 10,2024. Coming up on 2 years and have taken Tagrisso everyday! I have side effects and I try to deal with them the best I can. I have had good scans and my oncologists have been pleased. More scans this month. Praying for good results and praising God, my oncologists and my family for walking with me and my journey!

@almarodel Good for you! It's nice to celebrate what's going well in the journey. I applaud your stamina and your dealing with the side effects in dealing with the Tagrisso as best you can. Thank you for sharing and for being so positive.

@almarodel , these targeted therapies can be very effective. I've been on the same medication (for ALK positive NSCLC) for 6 years. I hope your scans go well!

@almarodel I have had a similar diagnosis and on tagrisso since Jan. 2026. The only problem that really bothers me is swollen, bruised and painful ankles. The oncologist put me on a medication to help get the swelling down. I had radiation on the skull where there was bone met that was painful on New Year's Eve, 12/31/25. I had I had 6 rounds of chemo w/cisplastin and alimpta, now I'm going through 3 more with just Alimpta and oral tagrisso 80 mg. My tumors have shrunk and some are gone. I can't believe it!
So nice to see encouraging stories here. Good luck to all.