Initial Reactions to COCOON Study’s Dermatologic/Nail AE Reductions

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

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

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

EP: 9.Operational Considerations: Workflow Adjustments and Monitoring Systems for Effective COCOON Implementation

EP: 10.COCOON in Practice: Patient Preparation, Key Insights, and Implementation Best Practices

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Prophylactic Management of Dermatologic Adverse Events With Amivantamab and Lazertinib Therapy

Overview

Panelists discuss the implementation and effectiveness of a proactive supportive care protocol for managing dermatologic and nail toxicities associated with the combination therapy of amivantamab and lazertinib in patients with cancer.

Key Points

Clinical Efficacy and Concerns

• The combination therapy has demonstrated improved outcomes, including significant 1-year survival benefit.
• Initial concerns centered on patient burden from multiple interventions: 2 cancer drugs plus prophylactic measures.

Dermatologic Adverse Events

• Dermatologic and nail toxicities are highlighted as challenging aspects of amivantamab and lazertinib therapy.
• These adverse effects can negatively impact:
• Quality of life

• Treatment adherence

• Patient social functioning

Prophylactic Protocol Results

• Data shows “meaningful reduction of grade 2 and higher events” with prophylactic management.
• The supportive care protocol validates the importance of early intervention.
• Proactive management has proven more effective than reactive management approaches

Patient Acceptability

• Despite initial concerns about treatment burden, patients appear receptive to preventive measures.
• Patients are motivated to avoid visible adverse effects (facial rash, scalp scabs, nail issues).
• The prophylactic regimen is described as “only mildly onerous” compared with its benefits.

Clinical Practice Implications

• The protocol strengthens provider confidence in recommending combination therapy.
• It allows clinicians to address adverse event concerns while emphasizing survival benefits.
• Both clinicians indicated they will recommend this prophylactic approach to all eligible patients.

Conclusion

The implementation of a proactive dermatologic adverse event management protocol appears to effectively mitigate one of the primary concerns with amivantamab and lazertinib therapy, making the survival benefits more accessible to patients without significant compromise to quality of life.