Optimizing Frontline Treatment Approaches in EGFRm Metastatic NSCLC - Episode 9
Weighing QoL and Toxicity in 1L EGFRm NSCLC Treatment Decisions
Panelists discuss how quality-of-life (QoL) considerations and individual toxicity profiles significantly impact first-line (1L) treatment decisions, with different regimens having distinct adverse effect profiles.
Quality-of-Life and Toxicity Considerations
Main Discussion Topics:
- Comparative toxicity profiles of available treatment regimens
- Impact of adverse effects on patient QoL
- Prophylactic strategies to mitigate treatment-related adverse events
Key Points for Physicians:
- Osimertinib monotherapy is extremely well tolerated with minimal impact on daily life
- FLAURA2 (chemotherapy + osimertinib) has more intensive induction followed by manageable maintenance
- Amivantamab + lazertinib has unique toxicities, including scalp rash, paronychia, hypoalbuminemia, and venous thromboembolism risk
Notable Insights:
Prophylactic strategies (COCOON for dermatologic toxicities; SKIPPirr for infusion reactions, anticoagulation) can significantly reduce adverse events with amivantamab/lazertinib.
Clinical Significance:
Selection of therapy requires careful assessment of toxicity profiles in the context of patient comorbidities, support systems, and preferences regarding appearance and lifestyle impact.
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