osimertinib
Trade name: tagrisso
Approved
Nov 13, 2015
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. Osimertinib is an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) that binds to certain mutant forms of EGFR (T790M, L858R, and exon 19 deletion) that predominate in non-small cell lung cancer (NSCLC) tumours following treatment with first-line EGFR-TKIs. As a third-generation tyrosine kinase inhibitor, osimertinib is specific for the gate-keeper T790M mutation which increases ATP binding activity to EGFR and results 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. Osimertinib is marketed under the brand name Tagrisso. — NCATS
Clinical trial activity
236 trials · 173 clinical orgs · 2 marketing orgs
Earliest trial started Mar 4, 2013 (NCT01802632)
Timeline
2010s
- Jan 1, 2013
AstraZeneca — Earliest Phase 1 Sponsor(trial)
- Jan 1, 2014
AstraZeneca — Earliest Phase 2 Sponsor(trial)
- Jan 1, 2014
AstraZeneca — Earliest Phase 3 Sponsor(trial)
- Sep 4, 2014
Orphan Drug Designation
- Nov 13, 2015
AstraZeneca — Earliest FDA Approval
- Nov 13, 2015
AstraZeneca — NDA Organization
- Nov 13, 2015
AstraZeneca — NDA Secondary Org
- Nov 13, 2015
AstraZeneca — Marketing Organization
2020s
- Jun 1, 2021
Zydus Discovery DMCC — Marketing Organization
Indications
Approved for
Studied for
- Adenocarcinoma · Phase 2
- Adenocarcinoma of Lung · Phase 2
- Antineoplastic Agents · Phase 1/Phase 2
- Bile Duct Neoplasms · Phase 2
- Brain Neoplasms · Phase 3
- Breast Neoplasms · Phase 2
- Bronchial Neoplasms · Phase 1/Phase 2
- Carcinoma · Phase 3
- Carcinoma, Bronchogenic · Phase 1/Phase 2
- Carcinoma, Squamous Cell · Phase 2
- Cell Cycle · Phase 2
- Cognition Disorders · Phase 2
- Colonic Neoplasms · Phase 2
- Colorectal Neoplasms · Phase 2
- Disease Progression · Phase 2
- Drugs, Investigational · Phase 3
- Drug Therapy · Phase 2
- Endometrial Neoplasms · Phase 2
- Epidermal Growth Factor · Phase 2
- Esophageal Neoplasms · Phase 2
- Genes, erbB-1 · Phase 2
- Genes, erbB-2 · Phase 2
- Glioblastoma · Phase 2
- Glioma · Phase 2
- Head and Neck Neoplasms · Phase 1
- Healthy Volunteers · Phase 1
- Immune Checkpoint Inhibitors · Phase 2
- Kidney Neoplasms · Phase 2
- Liver Neoplasms · Phase 2
- Lung Diseases · Phase 1/Phase 2
- Lung Neoplasms · Phase 3
- Lymphoma · Phase 2
- Melanoma · Phase 2
- Multiple Myeloma · Phase 2
- Mutation · Phase 3
- Neoplasm Metastasis · Phase 2
- Neoplasm, Residual · Phase 3
- Neoplasms by Histologic Type · Phase 1/Phase 2
- Neoplasms by Site · Phase 1/Phase 2
- Neoplasms, Nerve Tissue · Phase 1/Phase 2
- Neoplastic Cells, Circulating · Early Phase 1
- Ovarian Neoplasms · Phase 2
- Pancreatic Neoplasms · Phase 2
- Positron Emission Tomography Computed Tomography · Phase 2
- Progression-Free Survival · Phase 2/Phase 3
- Prostatic Neoplasms · Phase 2
- Protein Kinase Inhibitors · Phase 1/Phase 2
- Proto-Oncogene Proteins c-met · Phase 1/Phase 2
- Respiratory Tract Diseases · Phase 1/Phase 2
- Respiratory Tract Neoplasms · Phase 1/Phase 2
- Sarcoma · Phase 2
- Skin Neoplasms · Phase 2
- Small Cell Lung Carcinoma · Phase 3
- Squamous Cell Carcinoma of Head and Neck · Phase 2
- Stomach Neoplasms · Phase 2
- Thoracic Neoplasms · Phase 1/Phase 2
- Thyroid Neoplasms · Phase 2
- Tumor Suppressor Protein p53 · Phase 2
- Urinary Bladder Neoplasms · Phase 2
- Uterine Cervical Neoplasms · Phase 2
- Uterine Neoplasms · Phase 2
Mechanism of action
EGFR inhibitor
Irreversible inhibitor, selective for EGFR-TKI sensitizing and resistance T790M mutations
- Epidermal growth factor receptorINHIBITOR
Epidermal growth factor receptor inhibitor
Binds irreversibly to certain mutant forms of EGFR (T790M, L858R, and exon 19 deletion)
Approval history
- approvedPriority reviewAcceleratedFast trackBreakthroughNov 13, 2015
Chemistry & pharmacology
SMILES
C=CC(=O)Nc1cc(Nc2nccc(-c3cn(C)c4ccccc34)n2)c(OC)cc1N(C)CCN(C)C- Mol. weight
- 499.62 g/mol
- Lipinski Ro5
- Pass
- Rule of 3
- No
- Chirality
- Achiral Molecule
- Inorganic
- No
- Polymer
- No
- Delivery
- Oral
- Availability
- Prescription Only
Oral
Yes
Parenteral
No
Topical
No
Sources
- ChEMBLCHEMBL3353410 ↗
- WikipediaOsimertinib ↗
- NCATS3C06JJ0Z2O ↗
- ChEMBLCHEMBL3545063 ↗
Also known as
- azd9291
- azd9291
- azd9291
- azd 9291
- azd-9291
- azd-9291
- azd-9291
- azd-9291 mesylate
- azd-9291 mesylate
- azd9291 mesylate
- mereletinib
- mereletinib
- mereletinib
- n-(2-{[2-(dimethylamino)ethyl](methyl)amino}-4-methoxy-5-{[4-(1-methyl-1h-indol-3-yl)pyrimidin-2-yl]amino}phenyl)prop-2-enamide
- osimertinib
- osimertinib
- osimertinib
- osimertinib
- osimertinib
- osimertinib
- osimertinib
- osimertinib
- osimertinib
- osimertinib mesilate
- osimertinib mesylate
- osimertinib mesylate
- osimertinib mesylate
- osimertinib mesylate
- osimertinib mesylate
- osimertininb
- tagrisso
- tagrisso
- tagrisso
- tagrisso
- tagrisso
- tagrisso
Clinical trials
| NCT ID | Phase | Start date | Sponsor(s) |
|---|---|---|---|
| NCT07285148 | Phase 1/Phase 2 (Phase 2) | Jun 30, 2026 | Avistone Biotechnology Co., Ltd., Beijing Pearl Biotechnology Limited Liability Company |
| NCT07295821 | Phase 2 | Mar 9, 2026 | AstraZeneca |
| NCT07279935 | Phase 4 | Jan 15, 2026 | AstraZeneca |
| NCT07153055 | Phase 1/Phase 2 (Phase 2) | Nov 30, 2025 | Indiana University, Jazz Pharmaceuticals |
| NCT07256509 | Phase 2 | Nov 30, 2025 | Shijiazhuang Pharma Group (CSPC) |
| NCT07229729 | Phase 2 | Nov 30, 2025 | Hengrui Therapeutics, Inc. |
| NCT07206498 | Phase 1/Phase 2 (Phase 2) | Oct 17, 2025 | Wayshine Biopharm, Inc. |
| NCT07058519 | Phase 2 | Sep 23, 2025 | AstraZeneca, Jiao Tong University |
| NCT07177092 | Phase 2 | Sep 8, 2025 | Guangzhou Medical University |
| NCT07079475 | Phase 1/Phase 2 (Phase 2) | Aug 31, 2025 | Dizal (Jiangsu) Pharmaceutical Co., Ltd. |
| NCT07005102 | Phase 2/Phase 3 (Phase 3) | Aug 3, 2025 | AbbVie |
| NCT07038460 | Phase 2 | Jul 31, 2025 | Shantou University |
| NCT06908772 | Phase 2/Phase 3 (Phase 3) | Apr 1, 2025 | Shanghai JMT-Bio Inc. |
| NCT06895928 | Phase 2 | Mar 28, 2025 | Hengrui Therapeutics, Inc. |
| NCT06824792 | Phase 4 | Mar 1, 2025 | Chinese Academy of Medical Sciences, Government of China |
| NCT06838273 | Phase 3 | Feb 24, 2025 | Baili Pharmaceutical Group |
| NCT06829459 | Phase 3 | Feb 15, 2025 | Shanghai JMT-Bio Inc. |
| NCT06692491 | Phase 2 | Jan 1, 2025 | Peking University |
| NCT06630325 | Phase 2 | Jan 1, 2025 | AstraZeneca, Eli Lilly, OHSU Knight Cancer Institute, Oregon Health and Science University |
| NCT06752408 | Phase 2 | Dec 17, 2024 | Chinese Academy of Medical Sciences, Peking University |
Organizations
Research & Development (173)
| Organization | Org type | Trials | As lead sponsor | Phases | Earliest year |
|---|---|---|---|---|---|
| AstraZeneca | For profit | 78 | 49 | 5 | 2013 |
| National Cancer Institute (NCI) | Government | 16 | 10 | 3 | 2015 |
| Chinese Academy of Medical Sciences | Academic/Hospital | 12 | 7 | 3 | 2020 |
| Sun Yat-Sen University | Academic/Hospital | 9 | 4 | 3 | 2018 |
| Parexel | For profit | 7 | 0 | 2 | 2014 |
| Harvard University | Academic/Hospital | 6 | 3 | 2 | 2016 |
| Jiao Tong University | Academic/Hospital | 6 | 3 | 2 | 2020 |
| Memorial Sloan-Kettering Cancer Center | Academic/Hospital | 6 | 4 | 3 | 2018 |
| Shanghai JMT-Bio Inc. | For profit | 6 | 6 | 2 | 2021 |
| Sungkyunkwan University | Academic/Hospital | 6 | 5 | 1 | 2016 |
| University of Texas at Houston | Academic/Hospital | 6 | 4 | 3 | 2014 |
| Eli Lilly | For profit | 5 | 1 | 2 | 2016 |
| Shantou University | Academic/Hospital | 5 | 1 | 3 | 2014 |
| Baili Pharmaceutical Group | For profit | 4 | 4 | 2 | 2021 |
| Central South University | Academic/Hospital | 4 | 3 | 2 | 2020 |
| Daiichi Sankyo | For profit | 4 | 2 | 2 | 2017 |
| ECOG-ACRIN Cancer Research Group | Academic/Hospital | 4 | 0 | 2 | 2015 |
| Government of China | Government | 4 | 1 | 3 | 2022 |
| Huazhong University of Science and Technology | Academic/Hospital | 4 | 2 | 2 | 2021 |
| IQVIA | For profit | 4 | 0 | 2 | 2013 |
Marketing (4)
| Organization | Org type | Relationship | Date |
|---|---|---|---|
| AstraZeneca | For profit | NDA | Nov 13, 2015 |
| AstraZeneca | For profit | NDA2 | Nov 13, 2015 |
| AstraZeneca | For profit | MKTG | Nov 13, 2015 |
| Zydus Discovery DMCC | For profit | MKTG | Jun 1, 2021 |