Grading Toxicity and Preserving Dose Intensity in NSCLC

Panelists discuss how grading drives treatment decisions across first-line regimens for epidermal growth factor receptor (EGFR)-mutated advanced non-small cell lung cancer (NSCLC). The conversation describes the Common Terminology Criteria for Adverse Events as shared language for the multidisciplinary team, replacing subjective documentation such as bad rash or severe diarrhea with objective, function-based findings. Panelists outline supportive care for low-grade events, more aggressive intervention and possible holds at moderate grades, and interruption with consideration of dose reduction at higher grades, noting that the specific toxicity matters as much as the grade and that suspected pneumonitis is held and evaluated without waiting for severity to climb. The discussion then turns to dermatologic toxicity as a driver of nonadherence and self-discontinuation, covering sun-protective clothing and shade, prescribed topicals, soaks, emollients, dermatology referral, and reassurance that a brief planned hold allows recovery and continued treatment.