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Opinion|Videos|April 11, 2025

Brief Overview of Current Treatment Landscape for 1L EGFRm NSCLC

Author(s)Martin Dietrich, MD, PhD, Roy S. Herbst, MD, PhD

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.

Episodes in this series

2 experts in this video

EP. 1 Brief Overview of Current Treatment Landscape for 1L EGFRm NSCLC

2 experts in this video

EP. 2 Impressions of MARIPOSA Overall Survival and Potential Impact in Current SOC

2 experts in this video

EP. 3 Evaluating Chemotherapy-Free vs Chemotherapy-Containing Combos in First-Line EGFR-Mutated NSCLC: Pros and Cons

2 experts in this video

EP. 4 Decision-Making Factors in Choosing Combination Therapies in EGFR-Mutated NSCLC

2 experts in this video

EP. 5 Insights from MARIPOSA: Impressions of the Intracranial Data

2 experts in this video

EP. 6 Analysis of MARIPOSA & SKIPPirr Trials: Safety and Quality of Life

2 experts in this video

EP. 7 Assessing the Adverse Effect Profile of Ami-Laz in Comparison With Other Combination Therapies in EGFRm NSCLC

2 experts in this video

EP. 8 Looking Ahead and Key Takeaways in EGFRm NSCLC

Video content above is prompted by the following:

First-Line EGFRm NSCLC Treatment Landscape Overview

Current Treatment Options

The treatment landscape for EGFR-mutated (EGFRm) non–small cell lung cancer (NSCLC) has evolved significantly, with 3 strong first-line options now available:

Osimertinib monotherapy: The established standard treatment option
Osimertinib plus chemotherapy: Combination supported by the FLAURA2 trial data
Amivantamab plus lazertinib: Recent combination showing significant survival benefits in the MARIPOSA trial

Recent Advances: MARIPOSA Trial Results

The MARIPOSA trial, a randomized phase 3 study, compared 3 treatment regimens:

Amivantamab plus lazertinib
Osimertinib (control arm)
Lazertinib plus osimertinib

Key Findings:

Significant overall survival (OS) benefit: HR of 0.75 for amivantamab plus lazertinib compared with osimertinib monotherapy
Sustained survival advantage: Survival curves separating early and continuing to widen over time
Potential median OS improvement: Mathematical modeling suggesting up to 12-month difference in median survival (though median not yet reached for the treatment arm)
Impressive landmark data: Progressive improvement in survival difference at 24, 36, and 42 months

The amivantamab plus lazertinib combination represents a novel mechanism targeting both EGFR and c-MET receptors, providing a valuable new option for first-line treatment of EGFRm NSCLC.

The trial continues with follow-up for a 5-year landmark analysis, with current survival projections suggesting beyond 4 years of median OS for patients receiving the combination therapy.

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