Clinician Experiences: COCOON Regimen vs Traditional SoC AE Management

EP: 1.Clinical Insights: Experiences With Amivantamab-Lazertinib in EGFR-Mutant NSCLC

EP: 2.Overview of Study Design of the COCOON Trial

EP: 3.COCOON Baseline Characteristics

EP: 4.COCOON: Discussion of Clinical End Points and Dose Modifications

EP: 5.Initial Reactions to COCOON Study’s Dermatologic/Nail AE Reductions

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EP: 6.Clinician Experiences: COCOON Regimen vs Traditional SoC AE Management

EP: 7.Measuring Impact: Observed Differences in Dermatologic AEs Between COCOON Protocol and Standard Approaches

EP: 8.Building Support Systems: Resources and Multidisciplinary Collaboration for Optimizing COCOON Implementation

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Amivantamab Dermatologic Toxicity Management Protocol

Key Protocol Components

• Proactive Management Approach

Initiating doxycycline prophylactically before rash development

Using a predefined regimen that can be incorporated into standard order sets

• Specific Interventions

Chlorhexidine wash for fingernails and toenails to prevent periungual pyogenic granulomas and paronychia

Clindamycin lotion for scalp application (noted as being more practical than previously used antibiotic ointments)

Ceramide-containing moisturizers to restore skin barrier function, improve hydration, and reduce inflammation

Clinical Observations

• The protocol appears effective at preventing or minimizing common dermatologic adverse events associated with amivantamab
• Practitioners noted specific improvements in managing:
• Facial rash

• Periungual issues (granuloma tissue formation)

• Scalp reactions

• Overall skin dryness

Practitioner Perspectives

• Standardization was welcomed to address practice variability (“30 doctors doing things 45 different ways”).
• Previous approaches included various scalp treatments (steroid shampoos, Selsun Blue).
• The evidence-based protocol provides consistency in management across the practice.
• Protocol development involved input from investigators and dermatologists specializing in patients with cancer.

Conclusion

Implementation of this standardized prophylactic protocol appears to improve management of amivantamab-associated dermatologic toxicities through proactive intervention rather than reactive treatment, with positive feedback from practitioners regarding both efficacy and practical application.