Second-Line Treatment Selection After Progression on Chemo-Immunotherapy in HER2-Mutant NSCLC

Dr. Deborah Doroshow presents Sandra, a 54-year-old never-smoker diagnosed 14 months ago with stage IVA non-small cell lung cancer (NSCLC), adenocarcinoma subtype.

Dr. Doroshow addresses the critical gap that shaped Sandra's treatment trajectory: incomplete upfront molecular testing in community oncology.

This episode examines second-line therapy selection when brain metastases are present in HER2-mutant non-small cell lung cancer.

This episode focuses on practical decision-making for selecting among HER2-directed therapies after progression on chemo-immunotherapy.

This episode examines Dr. Doroshow's approach to safety counseling when selecting among HER2-directed therapies, with particular attention to Sandra's concern about interstitial lung disease risk given prior pembrolizumab exposure.

Dr. Doroshow addresses financial toxicity as a central concern in Sandra's case and broader challenge in HER2-directed therapy access. Sandra has high-deductible Affordable Care Act marketplace plan with $6,000 annual deductible, is currently on medical leave with uncertain prospects for returning to work and is understandably worried about out-of-pocket expenses that reset each calendar year.

This episode addresses how second-line HER2-directed therapy selection influences subsequent treatment options in advanced HER2-mutant non-small cell lung cancer.

In this final episode, Dr. Doroshow examines how HER2-mutant non-small cell lung cancer treatment will evolve over the next two years, then synthesizes key takeaways from Sandra's case.