Any benefits in using Tagrisso before surgery?

While I despise the design of the NeoADAURA trial for pooling early and late-stage lung cancers, it did prove something vital about neoadjuvant therapy in EGFR-mutated disease. The Major Pathological Response (MPR) rate, where 90% or more of active tumor cells are killed before surgery, jumped from 2% with chemotherapy alone to 26% when combining chemotherapy with Tagrisso.
That represents a 1,200% relative increase in tumor cell clearance across the trial population. While Tagrisso monotherapy alone hit 25% MPR, adding chemotherapy to it pushes that response up to 26%. A 1% increase might look small on a trial summary, but when you are fighting for every edge, stacking those 1%, 2%, and 5% gains can make a meaningful difference. If someone needs a major response prior to surgery, adding Tagrisso to chemotherapy provides a massive leap over chemo alone and squeezes out every possible benefit.

@ntmj1029, We've seen huge gains in how lung cancers are treated in recent years. One of the areas of advancement has been with these targeted therapies, like Tagrisso. They can be very effective, as I've experienced. As you noted, they all have their own set of side effects. We are also all unique and we all come into cancer treatment with a body that has history. Your overall health and ability to tolerate certain side effects all need to be considered in making these decisions.
Is your oncologist recommending the addition of Tagrisso? Have you started the chemo yet? How are you tolerating that?

Oncologist recommended Tagrisso with chemo but insurance denied Tagrisso because it was before surgery.
I started chemo and after a week had some issues such as fever for days with no source found. Lost most of my hair. Then had to take their antibiotics and steroids via IV to reduce fever.
Anyway if I can avoid chemo I would. I was given a sample pack Tagrisso from clinic for 7 days and biggest side effect I noticed was severe itching all over body. They told me to stop taking it after 7 days.
Anyone else experience severe side effects with Tagrisso? Such as itching or even worse pneumonitis

@ntmj1029
Did your oncologist already ask for a peer to peer review? The Neoadura trial is pretty remarkable in it's findings. Peer to peer can work immediately.
Here's two sources to back up your oncologists position

ascopost .com/issues/september-25-2025/neoadjuvant-osimertinib-in-the-perioperative-setting-for-resectable-egfr-mutated-nsclc/

actr.amegroups .org/article/view/12837/html

In lung cancer tsurvivordhio means learning to advocate for yourself. Do not take no for sn answer.

If peer to peer doesn't work ask for an Expedited external review. The window for neoadjuvant is short.

Good luck

@ntmj1029, Have you continued with the chemo? How are you feeling?
It's too bad that you experienced the skin issues that can come with Tagrisso. Some people do ok on a lower dose, if that's something that can be explored with your oncologist if they recommend that you take it later.

I have continued to cycle 2, they changed Taxol drug to Abraxane after an allergic reaction. I’m also back to taking 80mg Tagrisso after it was stopped for 3 weeks. So far now after about 12 days of it daily, not much itching.

@ntmj1029
This is one of those things people see on TV where they say don't use this drug if you're allergic to it or any of its ingredients. Abraxane and Taxol are both paclitaxel packaged in a different delivery medium. Taxol is packaged in Cremophor EL which many many people have a hard time with and the reason they premedicate you before the infusion. Abraxane is packaged in a human protein albumin. Our bodies already use this protein to transport all sorts of things through our blood.