Practical Considerations in the Treatment of EGFR-Mutant NSCLC and Application of Trial Data

Panelists discuss how the choice between amivantamab plus lazertinib and osimertinib hinges on practical considerations such as central nervous system (CNS) involvement, durability of response, and treatment tolerability. For patients with baseline brain metastases, osimertinib remains a trusted option given its demonstrated intracranial efficacy in the FLAURA trial, while combination therapy offers potential advantages in progression-free survival and intracranial control.

They explore how the MARIPOSA trial’s findings, showing improved median progression-free survival with the amivantamab–lazertinib regimen, are beginning to influence first-line decisions. The panel weighs these results against osimertinib’s established track record, debating whether monotherapy remains viable for select patients based on CNS burden, comorbidities, and preferences.

Clinicians further reflect on how real-world experiences align with clinical trial outcomes. While both options deliver meaningful CNS responses, practical aspects such as infusion logistics, toxicity management, and access to therapy shape everyday decision-making.