Martin Dietrich, MD, PhD

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.

Key AEs of NALIRIFOX in NAPOLI 3 were GI- and hematologic-related, with favorable rates of neutropenia and less growth factor use vs nab-paclitaxel/gemcitabine in mPDAC.

Martin F. Dietrich, MD, PhD, explains how NALIRIFOX dosing in the NAPOLI 3 trial resulted in lower rates of grade 3/4 neutropenia vs standard therapy for metastatic PDAC.

The NAPOLI 3 trial demonstrated that NALIRIFOX improved outcomes for patients with metastatic pancreatic ductal adenocarcinoma compared with the standard of care, nab-paclitaxel and gemcitabine.

Panelists discuss how overcoming resistance mechanisms in EGFR-mutated non–small cell lung cancer (NSCLC) remains a key unmet need, with future research focusing on targeting these mechanisms, exploring new drug combinations, and optimizing treatment sequences to improve patient outcomes.

Panelists discuss how the adverse effect profile of amivantamab plus lazertinib (ami-laz) compares with other combination therapies, emphasizing its balance between therapeutic efficacy and quality of life, and how this influences decision-making in treatment selection.

Panelists discuss how targeted cancer therapies, particularly those affecting the EGFR and c-MET receptors, present unique adverse effects such as dermatologic reactions and venous thromboembolism, emphasizing the importance of proactive management, patient education, and evolving treatment strategies to balance efficacy with quality of life.

Panelists discuss how intracranial progression-free survival (PFS) and duration of response (DoR) influence treatment decisions, highlighting the significance of intracranial data in differentiating this regimen within the treatment landscape, its potential impact on brain metastases management, and the role of radiation therapy in clinical practice.

Panelists discuss how the growing role of combination therapies in EGFR-mutated non–small cell lung cancer (NSCLC) influences the choice between the MARIPOSA and FLAURA2 trials, considering overall survival data, multidisciplinary implementation, patient education, and their impact on first-line prescribing decisions.

Panelists discuss how both chemotherapy-free and chemotherapy-containing combinations offer valuable treatment options for first-line EGFR-mutated non–small cell lung cancer (NSCLC) patients, with considerations including survival benefits, brain metastasis concerns, adverse effect profiles, and the evolution toward personalized treatment selection rather than viewing either approach as universally superior.

Panelists discuss how the significant overall survival (OS) benefit demonstrated by the new combination therapy (amivantamab-lazertinib) compared with standard monotherapy makes it a preferred treatment option for most patients despite a slightly increased toxicity and time commitment.

Panelists discuss how the treatment landscape for EGFR-mutated lung cancer has evolved, with 3 strong options now available, including single-agent osimertinib and 2 combinations: osimertinib plus chemotherapy (FLAURA2) and amivantamab plus lazertinib (MARIPOSA), with the latter showing significant overall survival benefits.

Medical oncologists discuss the overall research landscape in advanced EGFR-mutant NSCLC, highlighting exciting trials and emerging data in the evolving treatment space.

Martin Dietrich, MD, PhD, shares expert perspectives on recent data from TROPION-Lung05 and HERTHENA-Lung01 in advanced EGFR-mutant NSCLC.

Wade T. Iams, MD, provides clinical insights on proactive management strategies for patients receiving amivantamab for advanced EGFR-mutant NSCLC.

Focusing on treatment practices for patients with advanced EGFR-mutant NSCLC, Martin Dietrich, MD, PhD, discusses how the availability of subcutaneous amivantamab can potentially address current treatment barriers.

Wade T. Iams, MD, outlines insights gleaned from recently presented data from the PALOMA-3 trial in advanced EGFR-mutant non–small cell lung cancer.

Martin Dietrich, MD, PhD, discusses the secondary analysis from MARIPOSA evaluating first-line amivantamab plus lazertinib in patients with advanced EGFR-mutant NSCLC.

Following the 2024 ASCO Annual Meeting, medical oncologists share insights on how the availability of the FLAURA2 treatment regimen has impacted the treatment of patients with advanced EGFR-mutant non–small cell lung cancer (NSCLC).

The panelist summarizes the major findings from MARIPOSA-2 and their conclusions about amivantamab regimens improving outcomes in osimertinib-resistant NSCLC.

This segment summarizes the pivotal efficacy and safety outcomes from the MARIPOSA-2 trial of amivantamab-based regimens in osimertinib-resistant EGFR-mutant NSCLC. It explores the clinical implications of these data and potential future research directions.

A comprehensive look at the safety data from the MARIPOSA-2 trial, including rates of adverse events, toxicities, and treatment modifications across the three regimens. Specific details are provided on adverse event types and grades by the treatment arm.

This segment focuses on the key efficacy data on progression-free survival, response rates, and duration of response from MARIPOSA-2.

In this segment the panelist reviews the baseline patient and disease characteristics across the three treatment arms in MARIPOSA-2.

A commentary on key takeaways from TROPiCS-02, remaining questions and unmet needs in the field, and the clinical implications of using SG and other Trop-2–directed ADCs in patients with HR+/HER2- mBC.

Drs Dietrich, Tolaney, and Vidal comment on PFS subgroup analyses, response rates, and common adverse events (AEs) observed in the TROPiCS-02 trial.

Experts discuss progression-free survival (PFS) and overall survival (OS) data from the TROPiCS-02 trial on SG versus treatment of physician’s choice.

Dr Tolaney discusses the TROPiCS-02 study design and comments on the key baseline characteristics of the patients with HR+/HER2- mBC who were enrolled in the trial.

Dr Vidal elaborates on the role of trophoblast cell-surface antigen 2 (Trop-2) in metastatic breast cancer and discusses the rationale for using Trop-2–directed antibody-drug conjugates (ADCs), including sacituzumab govitecan (SG), in patients with the disease.