Geftinib (Osimertinib is newer drug preferred) is usually started in Non Small cell cancer
(Adeno carcinoma) if Patient is EGFR +ve, it usually responds well to the drug initially. The usual side effects are rash on the palms and soles and loose motions in some patients. The drug is continued till the disease is responding, stable or progressing only minimally (which may be a few months to a few years) If the disease shows rapid progression, 2nd line chemotherapy
may be considered depending upon the General condition and age of the patient. If lungs are filled with fluid, she may need insertion of intercostal drainage tube with pleurodesis if necessary. Also is the back pain
due to slip disk or bone metastasis. If bone metastasis then she may benefit from Bisphosphonates and / or palliative RT depending on the findings. Also immunotherapy drugs like nivolumab are showing promising results, but cost of almost 2lacs per month is a limiting factor.
If you want to share the detailed case history and reports, feel free to contact me directly.