Osimertinib is an irreversible third representative epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) for the treatment of non-small cell lung cancer (NSCLC) with T790M resistance and classical EGFR mutations. However, the therapeutic effectiveness of osimertinib is limited by acquired drug-resistance, poor water solubility and low tumor accumulation rates. Nanodrug delivery systems can increase the solubility and stability of drugs, prolong the blood circulation time of drugs, improve the uptake rate of cells, promote drug accumulation in tumor tissues, and improve drug resistance. Thus, they are effective in overcoming the limitations of traditional targeted drugs. In this study, we reviewed the mechanism of action of the third-generation EGFR-TKI osimertinib, focused on research advances in osimertinib nanodrug delivery systems against NSCLC, and explored the challenges and future development direction in this field.

A 53-year-old male patient who had a history of pulmonary tuberculosis with fever, hyperhidrosis with slight cough,in other hospital diagnosed as pulmonary tuberculosis,received quadruple anti tuberculosis therapy(isoniazid,rifampicin,pyrazinamide and ethambutol). On the 11th day of therapy,patients developed nasal bleeding and lower extremity ecchymosis petechiae,rapidly expanding to the whole body. On the 13th day,the patient was sent to our hospital,the blood routine examination showed his blood platelet count(PLT)was 1×109/L,the antituberculous drugs were discontinued,and the treatment of raising platelets,anti allergy,hemostasis and anti infection was given. On the 4th day of treatment,the patient's temperature returned to normal,the nasal bleeding stopped,and PLT was 18×109/L. On the 7th day,his body ecchymosis subside,and PLT was 92×109/L. On the 16th day,his PLT was 151×109/L, and multi-slice spiral CT examination showed right lower lung lesion was absorbed.

A 53-year-old male patient who had a history of pulmonary tuberculosis with fever, hyperhidrosis with slight cough,in other hospital diagnosed as pulmonary tuberculosis,received quadruple anti tuberculosis therapy(isoniazid,rifampicin,pyrazinamide and ethambutol). On the 11th day of therapy,patients developed nasal bleeding and lower extremity ecchymosis petechiae,rapidly expanding to the whole body. On the 13th day,the patient was sent to our hospital,the blood routine examination showed his blood platelet count(PLT)was 1×109/L,the antituberculous drugs were discontinued,and the treatment of raising platelets,anti allergy,hemostasis and anti infection was given. On the 4th day of treatment,the patient's temperature returned to normal,the nasal bleeding stopped,and PLT was 18×109/L. On the 7th day,his body ecchymosis subside,and PLT was 92×109/L. On the 16th day,his PLT was 151×109/L, and multi-slice spiral CT examination showed right lower lung lesion was absorbed.