Combination Therapy vs Monotherapy in EGFR-Mutated NSCLC

Wade T. Iams, MD, of Tennessee Oncology, says the stability of skin toxicity rates across 8.3 months of COPERNICUS follow-up, with 86% of participants still on study, gives him the most confidence in subcutaneous amivantamab plus lazertinib, and the near elimination of infusion reactions carries the most weight. Luis E. Raez, MD, of Miami Cancer Institute, adds that subcutaneous dosing spares patients ports. Weighing combination therapy vs monotherapy for epidermal growth factor receptor–mutated lung cancer, Dr Iams almost always prefers the combination for its survival benefit unless major medical conditions preclude it. Dr Raez considers combination therapy the standard of care, reserving monotherapy for select patients such as the very old. Dr Iams names continued follow-up as the main open safety question. Dr Raez closes by noting that COPERNICUS is single arm with immature efficacy data, and the next readout must show whether manageable toxicity means longer survival.