Can We Win the War Against Cancer? A Look at the Growing Crisis - Research Paper

Abstract

The ever-increasing mortality rate as a consequence of cancer has taken the world by storm, as medical practitioners and scientists alike engage in a daily battle to help the lives of patients across the globe. The rapid multiplication of cancer cells in a patient is the resultant factor that accelerates them to their deaths. The fact that cancer cells metastasize from one organ to the other render them a formidable foe. Through this, it becomes cumbersome to fight against cancer but watch the patient slowly spend their last days in agony. The invention of Tagrisso has revolutionized the approach to the cancer menace by the medical fraternity, through the use of Tagrisso containing the situation from spreading across several parts of the human body, which may lead, inevitably, to instant death. This paper seeks to evaluate in detail, the essence of Tagrisso, on its application in the medical field and its impact and effects.

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This paper aims to give the reader a perspective on the drug Tagrisso that is prescribed by physicians to cancer patients. The paper aims to present the primary use of the drug, the contraindications, interaction with other drugs, and finally, the pharmacokinetics and pharmacodynamics of the drug.

Introduction

Tagrisso is a drug manufactured by AstraZeneca. Its generic name is Osimertinib. It belongs to a class called EFGR inhibitors and is employed on non-small cell lung cancer that has metastasized in individuals who possess given types of EGFR (Epidermal Growth Factor) genes. Also, it is used on patients who have received an EGFR tyrosine kinase inhibitor and has failed. The physician, however, has to run some checks testing for the gene before prescribing this medicine (Chakradhar, T., Mondal, S., & Vanapalli, G. K., 2019).

The drug belongs to the family of medicines known as antineoplastics, and its action is by hindering the maturation of cancerous cells and are in effect ultimately destroyed. It is an EGFR inhibitor, meaning that it binds to specific sites of the EGFR gene to deter and ultimately stop the growth of cancerous cells.

Technical Details

The drug is metabolized in the liver via the Cytochrome P3A enzyme, a predominantly oxidative process, and dealkylation into two active metabolites, namely; az7550 and az5104. The drug is excreted in feces (68% with approximately 2% of that as an unchanged drug) and via urine (14% with around 2% as an unchanged drug). The drug has an estimated mean half-life of about 48hours. It has a 95% protein binding property (Chakradhar, T., Mondal, S., & Vanapalli, G. K., 2019).

The medicine is used as directed by the physician. Any questions and complications encountered while using the drug before and while using it are to be directed to the physician. The standard route of administration is the oral route. The medicine may be taken with or void of food. In the probable chance that one has trouble swallowing the tablets; one can dissolve it in 60ml of water. Put the tablet in the water and stir until it dissolves or until it is in small pieces. Avoid crushing or heating. Promptly drink the liquid (Cheema, M., Adial, A., Iftikhar, A., Singh, H., Trivedi, P., 2018).

Lung cancer has been one of the critical epidemics across the world that has been regarded as the leading course of death in many states. With over 18.4% of the overall global death population, it is indeed that lung cancer is a global threat to humanity (Jenkins, Cross, & Scudder, 2019). Tagrisso plays a specific role in curbing the mutation of the cancer cell, which reduces the rapid growth of cancer across different organs in the body.

Chakradhar, Mondal, and Vanapalli, (2019) observed that Kinase inhibitors are a class with several drugs under it, such as Osimertinib, which works by slowing down or completely stopping the replication of cancer cells. Through this, it binds epidermal growth factor receptor-EGFR in some tumors, resulting in slower growth of cancer cells.

The EGFR protein is responsible for the growth of cells in the human body, where patients who have lung cancer have a higher amount of EGFR protein, which accelerates their growth. In this case, the use of EGFR blocking drugs is used to intercept the relayed signals from the protein to the cell, which informs the cell to grow. However, these drugs tend to stop working over sometimes, as they become addictive in the body cells, and new mutation formed in the EGFR gene powers the protein once more (Jenkins, S., Cross, D., & Scudder, S. A., 2019).

The excessive protein in the cell continues issuing a signal to the cell, leading to cancer growth as the drugs are regarded as useless. As Jenkins et al., (2019) observed, T790M gene mutation is notorious and resistant to most of the EGFR blocking drugs. However, Tagrisso is a newer drug in the EGFR blocking drugs family that can work against T790M mutation cells.

As far as contraindications go, the manufacturer states that none are known.

Dosing

Before the application of the therapy, there has to be confirmation of the presence of EGFR T790M mutation in the tumor or specimens by a diagnostic test that is FDA approved. Also, due to the very high prevalence of the false-negative results, plasma testing is only an option in the event of the unavailability of a tumor biopsy or when such a sample cannot be obtained. Patients who get a negative on the plasma test should have the final diagnosis decided by having them reevaluated for a biopsy.

For adults the typical dose is 80mg of osimertinib once daily is the recommended dosage and is usually carried out until either intolerable toxicity occurs or till disease progression (Cheema, M., Adial, A., Iftikhar, A., Singh, H., Trivedi, P., 2018).

There are conditions whereby the drug usage could be modified to accommodate toxicity or drug interactions and sometimes even discontinue the use of the drug indefinitely, for instance, if interstitial lung disease or pneumonitis occurs, one has to discontinue the use of the drug indefinitely.

Effects of TagrissoBefore deciding to use this medicine, the shortcomings of taking the drug have to be weighed against the benefits. This is a decision arrived at by both the patient and the doctor upon careful consideration of several factors such as allergies, age, etc. (Chakradhar, T., Mondal, S., & Vanapalli, G. K., 2019).

This drug also has a particular kind of reaction based on the target group. The members of the same group may share a similar affliction that may predispose them to be subject to altered pharmacokinetic and pharmacodynamic response to the medication. These special populations include:

Hepatic Impairment: It has also been observed that the drug pharmacokinetics is not affected by mild or moderate hepatic impairment; therefore, there is no adjustment of dose that is required. Also, for severe hepatic impairment, there is a lack of sufficient data to be able to provide recommendations for proper dosage.

Renal Impairment: It has been shown that, via the analysis of pharmacokinetics of select populations, the drug pharmacokinetics are not altered by severe, mild, or moderate renal impairment. In this category also, no adjustment of dose is required for mild to severe renal impairment. For end-stage renal disease, however, sufficient data is void of providing recommendations for dosage.

Geriatric Patients: There are no specific dosage recommendations for this particular group.

Lactation: It is not conclusively established whether the drug is distributed into human milk or whether the drug has any effect on the production of milk. It is however advised to cease nursing during treatment with the drug and proceed as so for two weeks after the drug is halted.

Pregnancy

There is unavailability of data on pregnant women; study on animals and the mechanism of action of the drug that points to fatal harm. However, there is the potential of a fetal hazard if the drug is used during pregnancy or otherwise gets pregnant during therapy.

Pediatric:Relevant studies have not yet been conducted to correlate the effects of the drug to the age of the patient in the pediatric population. Establishment of efficacy and safety is still underway (Waring, M., 2018).

Use of the drug when one is pregnant can potentially harm the unborn child. It may also lead to congenital disabilities if the father is under it while his sexual partner is pregnant. Female patients should consider using effective birth control plans while being treated with this drug and for at the very least six weeks upon the last dose. Also, male patients should employ birth control measures during their treatment and maintain the same for at least 4 months upon the previous dose

Studies have shown that some men and women using this treatment have been rendered infertile (Cheema, M., Adial, A., Iftikhar, A., Singh, H., Trivedi, P., 2018).

This drug may also cause pneumonitis, which is the swelling of the lungs or even interstitial lung disease. The drug has also been observed to bring about heart complications. (Lindsley, W., 2016)

The more common side effects include; coughing, dizziness or passing out in the extreme case, eyes/vision variations, chest pain, inflammation of the arms or legs, slurred speech, sudden loss of coordination, migraines, troubled breathing, etc.

Despite the tremendous application of Tagrisso on non-small-cell growth, the use of the drug as the best option for lung cancer has several effects on the patient. Tagrisso patients are likely to suffer from diarrhea, dry skin, rashes as well as nail conditions such as redness around the fingernails. Never the less, the side effects may be adverse when it comes to several organs such as the lungs, and the heart (Chakradhar, T., Mondal, S., & Vanapalli, G. K., 2019). With the decrease in cell growth, which targets the cells in the lungs, it results in the burning of the cells around the organ, which may result in adverse effects to the patient. On the other hand, there is a severe effect on fetus development. Due to the nature of the drugs and its functioning, ability, cell growth in the body is brought under consistent surveillance, where all cell growth activities are affected, and so does the fetus growth gets affected.

Conclusion

The global use of Tagrisso has, by far, helped reduce the development of non-small cell growth, which is mutated and its effects metastasizing its way through the body. Never the less, the drug curbs the cell growth through the use of intercepting the protein signals from reaching the cell. In this case, the excessive protein, used to facilitate the development of growth signals into the cells is reduced. The drug does not seem to affect the select group in any harmful way, or at least no data is supporting this. It, however, seems to have some adverse effects on an unborn child when the drug is taken during pregnancy by both the maternal and paternal parent irrespective. However, one must agree that developing a remedy that aims to combat cancer is usually a challenge fundamentally because these cancerous cells are one's cells, not any foreign body. Thus designing a drug that targets one's cells is bound to come with some adverse side effects, but this drug tries to make a compromise, and it does it pretty well. Maybe its effects may be worse on an individual but may have outstanding effects on yet another individual.

References

Cheema, M., Adial, A., Iftikhar, A., Singh, H., Trivedi, P., (2018). Tagrisso Induced Lung Injury in Non-Small Cell Lung Cancer. American Journal of Respiratory and Critical Care Medicine, 197

Chakradhar, T., Mondal, S., & Vanapalli, G. K., (2019). New stability indicating RP-HPLC method for estimation of Osimertinib Mesylate. Journal of Drug Delivery and Therapeutics, 9(2-s), 391-395. DOI https://doi.org/10.22270/jddt.v9i2-s.2733

Lindsley, W., (2016). Novel drug approvals in 2015 and...