Optimizing Frontline Treatment Approaches in EGFRm Metastatic NSCLC - Episode 12
56-Year-Old Never-Smoker Female with High-Risk Metastatic EGFR-Mutant NSCLC Treated with the FLAURA2 Regimen
Panelists discuss how a 56-year-old patient with high-risk disease features was successfully treated with osimertinib plus chemotherapy, achieving excellent response before eventually discontinuing pemetrexed maintenance while continuing osimertinib.
Case Presentation 1 – High Disease Burden
Main Discussion Topics:
- Management of a 56-year-old never-smoker with high-burden metastatic disease
- Treatment selection process considering multiple high-risk features
- Response to therapy and subsequent maintenance decisions
Key Points for Physicians:
- Patient presented with multiple high-risk features: high disease burden, brain metastases, TP53 mutation, liver metastases
- FLAURA2 regimen (osimertinib + chemotherapy) was selected due to these factors and patient preference for longevity
- Toxicity management included osimertinib dose reduction and growth factor support
Notable Insights:
After approximately 1 year of therapy with excellent response, the patient elected to discontinue pemetrexed maintenance due to quality-of-life concerns, while continuing osimertinib.
Clinical Significance:
This case illustrates the real-world application of risk-stratified treatment selection, toxicity management, and evolving treatment decisions based on response and patient preferences.
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