Key Takeaways and Future Directions in the Management of EGFR-mutant NSCLC

Despite significant advances in targeted therapies for EGFR-mutant lung cancer, several unmet needs remain. One major challenge is defining what constitutes a meaningful clinical endpoint beyond overall survival, especially when some promising treatments narrowly miss statistical significance. This highlights the importance of involving patients and advocates in discussions about treatment goals and outcomes, as these directly impact quality of life and hope. Additionally, access to timely molecular testing and appropriate therapies, particularly in early-stage disease, continues to be a barrier that needs to be addressed to optimize patient care.

Another critical area for improvement lies in expanding clinical trial eligibility to include patients with poor prognoses, such as those with leptomeningeal disease, who are often excluded from studies despite their urgent need for novel therapies. Reevaluating trial designs to allow earlier access to experimental treatments for these patients could accelerate progress. Furthermore, there is growing interest in identifying subsets of patients with advanced disease who might benefit from aggressive, potentially curative approaches—such as prolonged systemic therapy combined with local treatments to residual disease—aiming to extend progression-free survival or even achieve cure in select cases.

Looking ahead, the complexity of the treatment landscape calls for more personalized strategies that tailor therapy to individual patient profiles and disease biology. This includes serial biopsies to guide treatment choices at each progression and better risk stratification to match patients with the most effective therapies. Additionally, education on managing side effects and supporting adherence is essential for optimizing outcomes. Overall, continued collaboration and rigorous testing of new approaches, combined with patient-centered care, will be key to advancing treatment and improving survival and quality of life for patients with EGFR-mutant lung cancer.