Osimertinib (Tagrisso)

CADTH recommends that Tagrisso should be reimbursed by public drug plans as adjuvant therapy after tumour resection for the treatment of adult patients with stage IB-IIIA (American Joint Committee on Cancer [AJCC] 7th edition staging system) non–small cell lung cancer (NSCLC) whose tumours have EGFR exon 19 deletions or exon 21 (L858R) substitution mutations only if certain conditions are met. Tagrisso should only be covered to treat adult patients (≥ 18 years) who have complete surgical resection of stage IB-IIIA (AJCC 7th edition staging system) or stage IIA to IIIB (AJCC 8th edition staging system) NSCLC with a confirmed sensitizing EGFR mutation (exon 19 deletion and/or exon 21 L858R substitution mutation), with or without chemotherapy after surgery, good performance status, and no significant relevant disease conditions. Patients should start treatment with Tagrisso within 10 weeks of surgery if chemotherapy was not given after the surgery, or within 26 weeks if chemotherapy was given after the surgery. Tagrisso should only be reimbursed for a total duration of 3 years, if prescribed by clinicians trained in treating cancer and experienced in the treatment of NSCLC, and if the cost of Tagrisso is reduced. Patients should be regularly monitored and treatment with Tagrisso should be stopped in patients with unacceptable toxicity or whose disease has recurred.