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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.

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    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.

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