Optimizing Frontline Treatment Approaches in EGFRm Metastatic NSCLC - Episode 13
45-Year-Old Never-Smoker with Advanced EGFR-Mutant NSCLC and CNS Metastases Treated with the MARIPOSA Regimen
Panelists discuss how a 45-year-old anxious patient who refused chemotherapy was successfully treated with amivantamab plus lazertinib along with prophylactic management strategies for potential adverse effects.
Case Presentation 2 – Patient With Treatment Preferences
Main Discussion Topics:
- Management of a 45-year-old preschool teacher with significant anxiety about treatment
- Addressing a patient’s strong preference against chemotherapy
- Implementation of prophylactic strategies for adverse event management
Key Points for Physicians:
- Patient with EGFR exon 21 mutation, numerous brain metastases, and adamant preference against chemotherapy
- Amivantamab + lazertinib selected as a chemotherapy-free option with demonstrated overall survival and central nervous system (CNS) benefits
- Comprehensive prophylactic measures implemented (dexamethasone premedication, skin prophylaxis, anticoagulation)
Notable Insights:
Patient education involved balancing data-driven information about efficacy with counseling about expected toxicities and management strategies.
Clinical Significance:
This case demonstrates how treatment selection can be successfully tailored to align with patient preferences while still providing optimal efficacy for high-risk disease features.
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