Proactive Patient Education Across First-Line EGFR Regimens

Panelists discuss the baseline workup nurses and advanced practice providers should complete before the first dose of first-line therapy for epidermal growth factor receptor (EGFR)-mutated advanced non-small cell lung cancer (NSCLC). The conversation covers a head-to-toe assessment at the first visit, including skin and nail evaluation, a pulmonary history documenting baseline cough, dyspnea, chronic obstructive pulmonary disease, and oxygen requirements, cardiac history with electrocardiography and QTc review, electrolytes, echocardiography to document ejection fraction in patients with cardiac history or at high risk, and an ocular symptom history. Panelists also review laboratory work before the first cycle, renal function before pemetrexed, venous thromboembolism risk assessment for patients starting amivantamab plus lazertinib, and medication reconciliation for strong CYP3A4 inhibitors and QT-prolonging agents, noting that acid-reducing agents are not the barrier with osimertinib that they are with some other oral oncolytics. The aim is a baseline detailed enough to identify changes early.