Alexander Spira, MD, PhD, FACP, FASCO

Experts discuss the benefits of combination therapies for non-small cell lung cancer, emphasizing improved survival rates and patient quality of life.

Explore the latest insights on combination therapies for metastatic cancer, focusing on long-term management and patient outcomes in challenging cases.

Health care professionals emphasize the importance of patient education on adverse effects of amivantamab and lazertinib to improve treatment adherence and outcomes.

Oncologists discuss effective strategies for safely implementing combination therapies while managing adverse events to enhance patient outcomes.

Experts discuss the efficacy of amivantamab and lazertinib in treating EGFR mutations, highlighting improved outcomes and reduced CNS metastases.

The experts focus on clinical trial evidence supporting the use of combination therapies in EGFR-mutant mNSCLC. The panel reviews key data from the MARIPOSA and FLAURA trials, highlighting differences in patient populations, CNS imaging protocols, and reported outcomes. They emphasize that routine CNS surveillance allows for a more accurate assessment of intracranial progression-free survival and can inform optimal therapy selection. MARIPOSA trial data demonstrate that amivantamab plus lazertinib significantly improves intracranial progression-free survival compared to osimertinib monotherapy, effectively doubling outcomes in patients with baseline brain metastases. The discussion also addresses the importance of patient stratification based on risk factors, including high tumor burden, liver metastases, p53 mutations, and circulating tumor DNA levels, which may impact prognosis and response to therapy. The panel emphasizes that combination therapy is beneficial across populations, not limited to high-risk patients, and stresses the significance of first-line therapy selection in improving long-term outcomes. Safety profiles and tolerability are also introduced, noting the need for patient education and shared decision-making.

This opening segment establishes the program’s focus on EGFR-mutant mNSCLC, emphasizing the importance of identifying high-risk patient populations and discussing new combination therapies. The panel introduces the challenges in managing patients with CNS metastases, highlighting the need for effective systemic treatments that also demonstrate intracranial activity. Key agents, such as osimertinib and combinations with amivantamab and lazertinib, are briefly introduced, demonstrating their potential to improve progression-free survival and overall survival. The experts discuss the critical balance between treatment efficacy and patient quality of life, noting the importance of considering performance status and potential adverse events when selecting therapies. This segment also highlights that treatment decisions should be individualized, incorporating shared decision-making with patients. The speakers stress that CNS monitoring and early intervention are increasingly essential, and combination regimens are being explored as first-line strategies to maximize long-term benefit.

Panelists discuss how proactive management of adverse effects through the COCOON protocol represents a paradigm shift that could be applied to other EGFR inhibitors, emphasizing early intervention before symptoms appear.

Panelists discuss how implementing standardized order sets in electronic medical records and providing printed patient education materials can help streamline the COCOON protocol implementation.

Panelists discuss how keeping management of dermatologic adverse effects “in-house” with oncology teams is often preferable to referring patients to dermatologists, though some patients occasionally benefit from specialized care for nail issues.

Panelists discuss how regular monitoring, patient education about reporting symptoms promptly, and visual assessment during biweekly visits are essential for effectively managing dermatologic adverse events.

Panelists discuss how the standardized COCOON regimen offers clear guidance for managing dermatologic adverse effects, with specific components such as clindamycin lotion for the scalp and chlorhexidine wash for nails showing effectiveness.

Panelists discuss how patients have been receptive to the proactive management approach that effectively reduces dermatologic adverse effects, despite initial concerns about adding multiple prophylactic interventions.

Panelists discuss how the COCOON dermatologic management protocol significantly reduced grade 2 or higher dermatologic adverse events in multiple locations, particularly on the face/body (23% vs 62%), scalp (9% vs 29%), and nails (16% vs 21%).

Panelists discuss how the baseline characteristics of patients in the COCOON trial were evenly matched, with slightly more women than men and a significant number of Asian patients, which is typical for EGFR-mutant non–small cell lung cancer.

Panelists discuss how the COCOON trial demonstrated that enhanced dermatologic management significantly reduced grade 2 or higher skin-related adverse events (38% vs 76%) compared with standard of care for patients receiving amivantamab plus lazertinib.

Panelists discuss how amivantamab plus lazertinib therapy for EGFR-mutant non–small cell lung cancer has shown promising survival data while highlighting the importance of managing adverse events for improved quality of life.

Explore the complexities of treating brain metastases in lung cancer patients, focusing on innovative systemic therapies and patient-centered approaches.

Healthcare professionals discuss the importance of individualized treatment plans for managing adverse events in patients undergoing cancer therapy.

Explore effective strategies for managing dermatologic adverse events in lung cancer patients, ensuring optimal care and patient comfort.