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Systemic Anti-Cancer Therapy Regimen Library

Home > LUNG NSCLC Adjuvant - osimertinib

LUNG NSCLC Adjuvant - osimertinib

Treatment Overview

Adjuvant osimertinib should ONLY be commenced after the completion of any planned adjuvant chemotherapy.

Cycles 1 to 36 - 30 days

Cycle length:
30

Cycle details

Cycles 1 to 36 - 30 days

Medication Dose Route Days Max Duration
doxycycline * 100 mg Once daily oral administration 0
hydrocortisone * 1 % Once daily topical administration 0
cetostearyl alcohol + paraffin liquid + paraffin soft white 50 g Once daily topical administration 0
avobenzone + homosalate + octisalate + octocrilene + oxybenzone 50 g topical administration 0
osimertinib 80 mg Once daily oral administration 1 to 30
loperamide 2 mg oral administration 1

Full details

Cycles 1 to 36 - 30 days

Day: 0

Medication Dose Route Max duration Details
doxycycline * 100 mg Once daily oral administration
Instructions:

To prevent rash.

Commence taking the day before osimertinib and continue for 6 weeks or as per institutional policy. If no rash develops after 6 weeks, consider stopping.

Take each dose with food and a large glass of water. Swallow whole, do not crush or chew. Remain sitting upright or standing for at least 30 minutes afterwards. Do not take indigestion remedies, iron or calcium preparations within 2 hours of taking this medicine. Protect yourself from too much natural or artificial sunlight while being treated with this medicine.
hydrocortisone * 1 % Once daily topical administration
Instructions:
Apply to the face, hands, feet, neck, back and chest at bedtime or as directed by your oncologist to prevent rash. If no rash develops after 6 weeks, consider stopping.
cetostearyl alcohol + paraffin liquid + paraffin soft white 50 g Once daily topical administration
Instructions:

Apply as a moisturiser to the face, hands, feet, neck, back and chest each morning or as directed by your oncologist.

Quantity is approximate only, prescriber discretion required.

Whilst this is a subsidised preparation, other moisturisers may also be suitable.
avobenzone + homosalate + octisalate + octocrilene + oxybenzone 50 g topical administration
Instructions:

SPF 50+ Sunscreen—apply to skin 30 minutes before going outdoors as directed by your oncologist.

Quantity is approximate only, prescriber discretion required.

Certified condition for subsidy. Whilst this is the subsidised preparation, alternative SPF 50+ sunscreen preparations may also be suitable.

Day: 1

Medication Dose Route Max duration Details
osimertinib 80 mg Once daily oral administration
Instructions:

Swallow whole with a glass of water, do not break crush or chew.

If unable to swallow tablets or to give via a nasogastric tube, see Tagrisso® NZ Medsafe Data Sheet.
loperamide 2 mg oral administration
Instructions:
Take TWO capsules (=4 mg) at onset of loose bowel motions and a further ONE capsule (=2 mg) for every loose bowel motion (maximum of EIGHT capsules in 24 hours), or use as directed by oncologist or haematologist.

Day: 2

Medication Dose Route Max duration Details
osimertinib 80 mg Once daily oral administration
Instructions:

Swallow whole with a glass of water, do not break crush or chew.

If unable to swallow tablets or to give via a nasogastric tube, see Tagrisso® NZ Medsafe Data Sheet.

Day: 3

Medication Dose Route Max duration Details
osimertinib 80 mg Once daily oral administration
Instructions:

Swallow whole with a glass of water, do not break crush or chew.

If unable to swallow tablets or to give via a nasogastric tube, see Tagrisso® NZ Medsafe Data Sheet.

Day: 4

Medication Dose Route Max duration Details
osimertinib 80 mg Once daily oral administration
Instructions:

Swallow whole with a glass of water, do not break crush or chew.

If unable to swallow tablets or to give via a nasogastric tube, see Tagrisso® NZ Medsafe Data Sheet.

Day: 5

Medication Dose Route Max duration Details
osimertinib 80 mg Once daily oral administration
Instructions:

Swallow whole with a glass of water, do not break crush or chew.

If unable to swallow tablets or to give via a nasogastric tube, see Tagrisso® NZ Medsafe Data Sheet.

Day: 6

Medication Dose Route Max duration Details
osimertinib 80 mg Once daily oral administration
Instructions:

Swallow whole with a glass of water, do not break crush or chew.

If unable to swallow tablets or to give via a nasogastric tube, see Tagrisso® NZ Medsafe Data Sheet.

Day: 7

Medication Dose Route Max duration Details
osimertinib 80 mg Once daily oral administration
Instructions:

Swallow whole with a glass of water, do not break crush or chew.

If unable to swallow tablets or to give via a nasogastric tube, see Tagrisso® NZ Medsafe Data Sheet.

Day: 8

Medication Dose Route Max duration Details
osimertinib 80 mg Once daily oral administration
Instructions:

Swallow whole with a glass of water, do not break crush or chew.

If unable to swallow tablets or to give via a nasogastric tube, see Tagrisso® NZ Medsafe Data Sheet.

Day: 9

Medication Dose Route Max duration Details
osimertinib 80 mg Once daily oral administration
Instructions:

Swallow whole with a glass of water, do not break crush or chew.

If unable to swallow tablets or to give via a nasogastric tube, see Tagrisso® NZ Medsafe Data Sheet.

Day: 10

Medication Dose Route Max duration Details
osimertinib 80 mg Once daily oral administration
Instructions:

Swallow whole with a glass of water, do not break crush or chew.

If unable to swallow tablets or to give via a nasogastric tube, see Tagrisso® NZ Medsafe Data Sheet.

Day: 11

Medication Dose Route Max duration Details
osimertinib 80 mg Once daily oral administration
Instructions:

Swallow whole with a glass of water, do not break crush or chew.

If unable to swallow tablets or to give via a nasogastric tube, see Tagrisso® NZ Medsafe Data Sheet.

Day: 12

Medication Dose Route Max duration Details
osimertinib 80 mg Once daily oral administration
Instructions:

Swallow whole with a glass of water, do not break crush or chew.

If unable to swallow tablets or to give via a nasogastric tube, see Tagrisso® NZ Medsafe Data Sheet.

Day: 13

Medication Dose Route Max duration Details
osimertinib 80 mg Once daily oral administration
Instructions:

Swallow whole with a glass of water, do not break crush or chew.

If unable to swallow tablets or to give via a nasogastric tube, see Tagrisso® NZ Medsafe Data Sheet.

Day: 14

Medication Dose Route Max duration Details
osimertinib 80 mg Once daily oral administration
Instructions:

Swallow whole with a glass of water, do not break crush or chew.

If unable to swallow tablets or to give via a nasogastric tube, see Tagrisso® NZ Medsafe Data Sheet.

Day: 15

Medication Dose Route Max duration Details
osimertinib 80 mg Once daily oral administration
Instructions:

Swallow whole with a glass of water, do not break crush or chew.

If unable to swallow tablets or to give via a nasogastric tube, see Tagrisso® NZ Medsafe Data Sheet.

Day: 16

Medication Dose Route Max duration Details
osimertinib 80 mg Once daily oral administration
Instructions:

Swallow whole with a glass of water, do not break crush or chew.

If unable to swallow tablets or to give via a nasogastric tube, see Tagrisso® NZ Medsafe Data Sheet.

Day: 17

Medication Dose Route Max duration Details
osimertinib 80 mg Once daily oral administration
Instructions:

Swallow whole with a glass of water, do not break crush or chew.

If unable to swallow tablets or to give via a nasogastric tube, see Tagrisso® NZ Medsafe Data Sheet.

Day: 18

Medication Dose Route Max duration Details
osimertinib 80 mg Once daily oral administration
Instructions:

Swallow whole with a glass of water, do not break crush or chew.

If unable to swallow tablets or to give via a nasogastric tube, see Tagrisso® NZ Medsafe Data Sheet.

Day: 19

Medication Dose Route Max duration Details
osimertinib 80 mg Once daily oral administration
Instructions:

Swallow whole with a glass of water, do not break crush or chew.

If unable to swallow tablets or to give via a nasogastric tube, see Tagrisso® NZ Medsafe Data Sheet.

Day: 20

Medication Dose Route Max duration Details
osimertinib 80 mg Once daily oral administration
Instructions:

Swallow whole with a glass of water, do not break crush or chew.

If unable to swallow tablets or to give via a nasogastric tube, see Tagrisso® NZ Medsafe Data Sheet.

Day: 21

Medication Dose Route Max duration Details
osimertinib 80 mg Once daily oral administration
Instructions:

Swallow whole with a glass of water, do not break crush or chew.

If unable to swallow tablets or to give via a nasogastric tube, see Tagrisso® NZ Medsafe Data Sheet.

Day: 22

Medication Dose Route Max duration Details
osimertinib 80 mg Once daily oral administration
Instructions:

Swallow whole with a glass of water, do not break crush or chew.

If unable to swallow tablets or to give via a nasogastric tube, see Tagrisso® NZ Medsafe Data Sheet.

Day: 23

Medication Dose Route Max duration Details
osimertinib 80 mg Once daily oral administration
Instructions:

Swallow whole with a glass of water, do not break crush or chew.

If unable to swallow tablets or to give via a nasogastric tube, see Tagrisso® NZ Medsafe Data Sheet.

Day: 24

Medication Dose Route Max duration Details
osimertinib 80 mg Once daily oral administration
Instructions:

Swallow whole with a glass of water, do not break crush or chew.

If unable to swallow tablets or to give via a nasogastric tube, see Tagrisso® NZ Medsafe Data Sheet.

Day: 25

Medication Dose Route Max duration Details
osimertinib 80 mg Once daily oral administration
Instructions:

Swallow whole with a glass of water, do not break crush or chew.

If unable to swallow tablets or to give via a nasogastric tube, see Tagrisso® NZ Medsafe Data Sheet.

Day: 26

Medication Dose Route Max duration Details
osimertinib 80 mg Once daily oral administration
Instructions:

Swallow whole with a glass of water, do not break crush or chew.

If unable to swallow tablets or to give via a nasogastric tube, see Tagrisso® NZ Medsafe Data Sheet.

Day: 27

Medication Dose Route Max duration Details
osimertinib 80 mg Once daily oral administration
Instructions:

Swallow whole with a glass of water, do not break crush or chew.

If unable to swallow tablets or to give via a nasogastric tube, see Tagrisso® NZ Medsafe Data Sheet.

Day: 28

Medication Dose Route Max duration Details
osimertinib 80 mg Once daily oral administration
Instructions:

Swallow whole with a glass of water, do not break crush or chew.

If unable to swallow tablets or to give via a nasogastric tube, see Tagrisso® NZ Medsafe Data Sheet.

Day: 29

Medication Dose Route Max duration Details
osimertinib 80 mg Once daily oral administration
Instructions:

Swallow whole with a glass of water, do not break crush or chew.

If unable to swallow tablets or to give via a nasogastric tube, see Tagrisso® NZ Medsafe Data Sheet.

Day: 30

Medication Dose Route Max duration Details
osimertinib 80 mg Once daily oral administration
Instructions:

Swallow whole with a glass of water, do not break crush or chew.

If unable to swallow tablets or to give via a nasogastric tube, see Tagrisso® NZ Medsafe Data Sheet.

Supportive Care Factors

Factor Value
Diarrhoea risk: Anti-diarrhoeals are usually prescribed with this treatment
Emetogenicity: Minimal to low

Emetogenicity: Antiemetics may be required with continuous dosing of oral anti-cancer medicines with MINIMAL to LOW emetic risk; an individualised approach is appropriate. 

References

Wu, Y. L., M. Tsuboi, J. He, et al. 2020. "Osimertinib in Resected EGFR-Mutated Non-Small-Cell Lung Cancer." N Engl J Med 383(18):1711-1723., PMID: 32955177

Majem, M., J. W. Goldman, T. John, et al. 2022. "Health-Related Quality of Life Outcomes in Patients with Resected Epidermal Growth Factor Receptor-Mutated Non-Small Cell Lung Cancer Who Received Adjuvant Osimertinib in the Phase III ADAURA Trial." Clin Cancer Res 28(11):2286-2296., PMID: 35012927

AstraZeneca Limited. Tagrisso® New Zealand Data Sheet 16 August 2022. https://www.medsafe.govt.nz/profs/Datasheet/l/lenvimacap.pdf (Accessed 15 Feb 2023)

Hofheinz RD, Deplanque G, Komatsu Y, et al. Recommendations for the Prophylactic Management of Skin Reactions Induced by Epidermal Growth Factor Receptor Inhibitors in Patients With Solid Tumors. Oncologist. 2016;21(12):1483-1491. doi:10.1634/theoncologist.2016-0051, PMID: 27449521

Lacouture ME, Anadkat MJ, Bensadoun RJ, Bryce J, Chan A, Epstein JB, Eaby-Sandy B, Murphy BA; MASCC Skin Toxicity Study Group. Clinical practice guidelines for the prevention and treatment of EGFR inhibitor-associated dermatologic toxicities. Support Care Cancer. 2011 Aug;19(8):1079-95. doi: 10.1007/s00520-011-1197-6. Epub 2011 Jun 1., PMID: 21630130

Deplanque G, Gervais R, Vergnenegre A, Falchero L, Souquet PJ, Chavaillon JM, Taviot B, Fraboulet G, Saal H, Robert C, Chosidow O. Doxycycline for prevention of erlotinib-induced rash in patients with non-small-cell lung cancer (NSCLC) after failure of first-line chemotherapy: A randomized, open-label trial. Journal of the American Academy of Dermatology. 2016 Jun 1;74(6):1077-85., PMID: 26946985

Dika, E., & Patrizi, A. (2017). Prevention of erlotinib-induced folliculitis with doxycycline. Dermatologic therapy, 30(1), https://doi.org/10.1111/dth.12419 , PMID: 27592506

* The medicines, doses, combinations, and schedule in this treatment regimen have been carefully reviewed against international best practice guidelines by specialists in medical oncology around New Zealand and this advice has been accepted for publication by Te Aho o Te Kahu (the Cancer Control Agency). Sometimes medicines that are used in routine clinical practice have not been through a formal review process by the NZ Medicines Regulator Medsafe and are therefore considered unapproved or off-label. These medicines are legally able to be prescribed through sections 25 and 29 of the Medicines Act and by obtaining informed consent from patients. All treatment regimens listed on this website have been through robust peer review and are considered an accepted standard of care, whether prescribed through sections 25 or 29 or carrying formal Medsafe Approval.

s29: This symbol indicates that some formulations of the associated medicine are legally only able to be prescribed under section 29 of the Medicines Act. You can see which formulations are section 29 by hovering over the s29 symbol. You can access full medication details from the New Zealand Formulary by clicking on the medication name. Each clinician retains full responsibility for ensuring they have complied with all relevant obligations and requirements of section 29 including obtaining informed patient consent prior to prescribing the applicable medicine.