Cancer Treatment Today

Using erlotinib (Tarceva) after Tagrisso (osimertinib) is generally not the standard of care, as Tagrisso is a third-generation EGFR inhibitor designed to overcome resistance to first-generation inhibitors like erlotinib. Similiarly, using gefitinib (Iressa) after Tagrisso (osimertinib) is generally not standard care, as Tagrisso is a superior, next-generation inhibitor designed to overcome resistance to earlier drugs like gefitinib. However, Lacluze is not supported by current medical literature after Tagrisso

Lazcluze for Metastatic EGFR L858R-mutated lung adenocarcinoma is under review. LAZCLUZE (lazertinib) is an oral, third-generation EGFR tyrosine kinase inhibitor (TKI) approved in August 2024 in combination with amivantamab-vmjw, is approved for the first-line treatment of adults with locally advanced or metastatic non-small cell lung cancer (NSCLC) harboring EGFR exon 19 deletions or exon 21 L858R substitution mutations. There is evidence that Rybrevant plus chemotherapy improved median PFS and ORR compared to chemotherapy alone in EGFR-mutated NSCLC patients post-Tagrisso progression, that was presented at the 2025 American Society of Clinical Oncology Annual Meeting. Rybrevant plus chemotherapy improved median PFS and ORR compared to chemotherapy alone in EGFR-mutated NSCLC patients post-Tagrisso progression. One arm also used Lacluze. I did not find any studies on Lacluze use of Tagrisso.

Amivantamab plus chemotherapy versus chemotherapy in EGFR-mutant advanced NSCLC after disease progression on Tagrisso: Outcomes by Tagrisso resistance mechanisms in MARIPOSA-2” by Dr. Raffaele Califano, et al., presented at the 2025 American Society of Clinical Oncology Annual Meeting