Optimizing Frontline Treatment Approaches in EGFRm Metastatic NSCLC - Episode 7

Balancing Clinical and Patient-Centered Factors in 1L EGFRm NSCLC Treatment

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Panelists discuss how patient-centered factors are crucial in shared decision-making for first-line (1L) treatment, with a potential default approach of offering combination therapy with an option to choose osimertinib monotherapy.

Patient-Centered Factors in Treatment Decision-Making

Main Discussion Topics:

  • Incorporating patient goals and preferences into treatment selection
  • Approaches to shared decision-making in time-limited clinical visits
  • Use of risk stratification strategies to guide treatment intensity

Key Points for Physicians:

  • With significant survival data, combination therapy may become the default with an “opt-out” approach
  • Liquid biopsy (circulating tumor DNA clearance) can help stratify patients who might benefit from treatment escalation
  • All treatments (chemotherapy, amivantamab, EGFR inhibitors) will likely be used at some point in the disease course

Notable Insights:

Treatment sequencing must consider that not all patients receive 2L therapy, making it critical to optimize 1L treatment selection.

Clinical Significance:

A nuanced approach to 1L therapy involves balancing evidence-based recommendations with individualized assessment of risk and patient preferences.