An expert on EGFR+ non–small cell lung cancer discusses factors that influence treatment decisions.
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 discusses deciding between the treatment options of osimertinib monotherapy, osimertinib plus chemotherapy (FLAURA2 trial), and amivantamab plus lazertinib (MARIPOSA trial) for frontline EGFR-mutated non-small cell lung cancer (NSCLC).
Considerations include patient factors like age, comorbidities, performance status, and toxicity tolerance. Osimertinib alone may be preferred for older, frailer patients to limit toxicity and visits. The amivantamab plus lazertinib combination could be utilized in younger, fitter patients due to the dual EGFR- and MET-targeting approach and immune activation.
For brain metastases, the MARIPOSA-2 data for EGFR patients pretreated with a tyrosine kinase inhibitor showed no additional central nervous system benefit from adding lazertinib to amivantamab plus chemotherapy. However, the MARIPOSA trial showed that upfront lazertinib may contribute to central nervous system control. Comparisons to FLAURA2 are difficult since routine brain imaging differed between trials.
Patient selection and balancing efficacy and toxicity are important when deciding between these emerging frontline options for eligible patients with EGFR-mutated NSCLC.
Video synopsis is AI-generated and reviewed by Targeted Oncology™ editorial staff.
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