Joshua K. Sabari, MD, offers key takeaways on treating patients with EGFR+ non–small cell lung cancer, highlighting the safety profile.
Case: A 73-Year-Old Man with EGFR+ NSCLC
Clinical Presentation:
Past Medical History:
Social History:
Initial Clinical Workup and Diagnosis:
Physical Examination
Pulmonary Function Tests
Imaging Studies:
Diagnostic Procedure:
Neoadjuvant Therapy and Surgical Resection:
Surgical Pathology Report:
Six Months Later:
Second Line Systemic Therapy:
Repeat Imaging at 8 Weeks:
This is a video synopsis/summary of a Case-Based Peer Perspectives featuring Joshua K. Sabari, MD.
Sabari summarizes that patients want to live and live well, and most are willing to tolerate toxicity risks for potential survival benefit. While patient factors impact regimen selection, combination therapies with novel mechanisms of action are important to advance outcomes. All patients with lung cancer should have molecular profiling, including at early stages, because anyone can harbor targetable mutations.
Once an EGFR mutation is identified, mutation specifics matter: exon 19/L858R patients have better prognoses and more options than the rarer exon 20 insertions. Combinations like amivantamab-lazertinib in the MARIPOSA trial help exon 19/L858R patients, while amivantamab has become standard for first-line exon 20 mutated lung cancer based on the PAPILLON trial. More combinations utilizing new antibody-drug conjugates, T-cell engagers, and other novel agents with EGFR inhibitors represent promising future directions.
The key messages are to test all patients, understand the implications of specific mutations, have transparent discussions regarding benefits/risks, and sequence therapy appropriately to extend life and maintain quality.
Video synopsis is AI-generated and reviewed by Targeted Oncology™ editorial staff.
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