The MARIPOSA Regimen: Efficacy and Toxicity Management in Frontline EGFR-Mutant NSCLC

This segment addresses the chemotherapy-free combination of amivantamab and lazertinib as a first-line option and its distinct safety profile. The faculty note that this regimen improved both progression-free and overall survival versus monotherapy, with outcomes broadly comparable to the chemotherapy combination, and that the greatest benefit tends to fall to higher-risk patients. The bulk of the discussion centers on proactive toxicity management, since avoiding chemotherapy does not mean avoiding toxicity. Faculty describe the venous thromboembolism risk that warrants prophylactic anticoagulation, the prominent dermatologic effects and paronychia, and structured prevention with prophylactic antibiotics, topical measures, and diligent skin care, ideally with dermatology partnership. They also cover infusion-related reactions and how the subcutaneous formulation reduces them and eases administration, along with practical nuances of the newer delivery approach. The takeaway is that this regimen demands upfront patient education and a coordinated supportive-care plan to be delivered successfully.