Adverse Drug Reaction Classification System

Pharmaceutical Information
Drug Name Osimertinib
Drug ID BADD_D01629
Description Osimertinib is an oral, third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) drug developed by AstraZeneca Pharmaceuticals. Its use is indicated for the treatment of metastatic non-small cell lung cancer (NSCLC) in cases where tumour EGFR expression is positive for the T790M mutation as detected by FDA-approved testing and which has progressed following therapy with a first-generation EGFR tyrosine kinase inhibitor. Approximately 10% of patients with NSCLC have a rapid and clinically effective response to EGFR-TKIs due to the presence of specific activating EGFR mutations within the tumour cells. More specifically, deletions around the LREA motif in exon 19 and exon 21 L858R point mutations are correlated with response to therapy. Development of third-generation EGFR-TKIs, such as osimertinib, has been in response to altered tumour resistance patterns following treatment and toxic side effects that impact patient quality of life. Treatment with first-generation EGFR-TKIs (gefitinib and erlotinib) has been associated with the development of resistance through activating mutations in the EGFR gene. Second-generation EGFR-TKIs (afatinib and dacomitinib) were then developed to be more potent inhibitors, although their use is associated with increased toxicity through nonspecific targeting of wild-type EGFR. In contrast, third-generation inhibitors are specific for the gate-keeper T790M mutations which increases ATP binding activity to EGFR and result in poor prognosis for late-stage disease. Furthermore, osimertinib has been shown to spare wild-type EGFR during therapy, thereby reducing non-specific binding and limiting toxicity.
Indications and Usage Osimertinib is indicated for the treatment of patients with metastatic epidermal growth factor receptor (EGFR) T790M mutation-positive non-small cell lung cancer (NSCLC), as detected by an FDA- approved test, who have progressed on or after EGFR-TKI therapy.
Marketing Status Prescription
ATC Code L01EB04
DrugBank ID DB09330
KEGG ID D10766
MeSH ID C000596361
PubChem ID 71496458
TTD Drug ID D0O8GK
NDC Product Code 0310-1354; 0310-1353; 17228-1349; 54864-844; 0310-1350; 0310-1349; 17228-1350
Synonyms osimertinib | Tagrisso | AZD9291
Chemical Information
Molecular Formula C28H33N7O2
CAS Registry Number 1421373-65-0
SMILES CN1C=C(C2=CC=CC=C21)C3=NC(=NC=C3)NC4=C(C=C(C(=C4)NC(=O)C=C)N(C)CCN(C)C)OC
Chemical Structure
ADR Related Proteins Induced by Drug
ADR Term Protein Name UniProt AC TTD Target ID PMID
Not AvailableNot AvailableNot AvailableNot AvailableNot Available
ADRs Induced by Drug
ADR Term ADReCS ID ADR Frequency (FAERS) ADR Severity Grade (FAERS) ADR Severity Grade (CTCAE)
Skin disorder23.03.03.0070.002131%Not Available
Skin exfoliation23.03.07.0030.001332%Not Available
Skin fissures23.03.03.0080.000533%Not Available
Skin infection23.09.04.002; 11.01.12.0030.000533%
Skin lesion23.03.03.0100.000799%Not Available
Skin ulcer24.04.03.007; 23.07.03.0030.002398%
Small cell lung cancer22.08.01.013; 16.19.08.0030.000486%Not Available
Somnolence19.02.05.003; 17.02.04.006--
Spinal compression fracture12.04.04.001; 15.08.05.004; 14.04.04.0030.000139%Not Available
Squamous cell carcinoma16.16.01.0020.000799%Not Available
Stevens-Johnson syndrome23.03.01.007; 12.03.01.014; 11.07.01.005; 10.01.03.0200.001865%
Stomatitis07.05.06.0050.006394%
Subdural haematoma24.07.04.005; 17.08.05.002; 12.01.10.0030.001066%Not Available
Sudden death08.04.01.003; 02.03.04.0130.000208%
Supraventricular extrasystoles02.03.03.0110.000533%Not Available
Supraventricular tachycardia02.03.03.0120.000799%
Swelling face23.04.01.018; 10.01.05.018--Not Available
Syncope24.06.02.012; 17.02.04.008; 02.01.02.008--
Tachycardia02.03.02.007--Not Available
Thrombocytopenia01.08.01.0020.009058%Not Available
Thrombophlebitis24.01.02.0010.000533%Not Available
Thrombosis24.01.01.006--Not Available
Toxic epidermal necrolysis23.03.01.008; 12.03.01.015; 11.07.01.006; 10.01.01.0060.000799%
Transient ischaemic attack24.04.06.005; 17.08.04.001--
Tremor17.01.06.002--
Tumour flare16.32.03.0010.000799%Not Available
Ulcer08.03.06.0010.000533%Not Available
Urinary retention20.02.02.011--
Urinary tract infection20.08.02.001; 11.01.14.004--
Urticaria23.04.02.001; 10.01.06.001--
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