Extended Anticoagulation and Skin Care Adherence on Amivantamab

Wade T. Iams, MD, of Tennessee Oncology, and Luis E. Raez, MD, of Miami Cancer Institute, discuss anticoagulation after the 4-month window and what happens when patients stop skin prophylaxis early on amivantamab plus lazertinib. Dr Iams treats continued anticoagulation as an individual risk-benefit decision, uses the Khorana risk score, and typically continues prophylactic dosing in patients who tolerate it without bleeding. Dr Raez notes that thrombosis risk does not disappear at 4 months and may be higher when disease is not controlled; in some patients he takes a middle path, such as low-dose aspirin, fluids, and activity. Dr Iams has seen missed doxycycline lead to papular erythematous chest rash and missed clindamycin worsen facial rash, which can take months to settle. Dr Raez finds that some patients stop doxycycline because they think it treats infection, so he explains that it works as a daily anti-inflammatory.