Benjamin P. Levy, MD

Benjamin P. Levy, MD, explains the rationale for dual EGFR and HER3 targeting with iza-bren and the open sequencing questions after osimertinib.

Benjamin P. Levy, MD, explains how patient factors, TP53 co-mutations, and brain metastases guide his first-line choices in EGFR-mutant lung cancer.

Benjamin P. Levy, MD, discusses how osimertinib-based and amivantamab-based combinations are reshaping first-line care for EGFR-mutated non-small cell lung cancer.

Kamel Abou Hussein, MD, explains why breast oncologists score programmed death-ligand 1 (PD-L1) using the combined positive score (CPS) rather than the tumor proportion score, since PD-L1 expression in breast cancer sits mainly in the immune microenvironment

Benjamin Levy, MD, opens a discussion with Kamel Abou Hussein, MD, Nicholas Hornstein, MD, PhD, and Nicole Balmaceda, MD, on how biomarkers differ across tumor types, then explains how programmed death-ligand 1 (PD-L1) guides treatment in non-small cell lung cancer.

In this segment of the OncLive Peer Exchange®, Dr. Benjamin P. Levy, Dr. Julia Rotow, and Dr. Narjust Florez discuss challenges associated with tissue adequacy and repeat biopsy in non-small cell lung cancer (NSCLC), including HER2-mutant disease.

In this segment of the OncLive Peer Exchange®, Dr. Benjamin P. Levy introduces the evolving treatment landscape for HER2-mutant non-small cell lung cancer (NSCLC) and welcomes panelists Dr. Julia Rotow and Dr. Narjust Florez.

Dr. Camidge predicts TROP2-directed ADCs will become obsolete due to poor tolerability profiles, while better-tolerated ADC platforms will emerge. He anticipates advances in understanding persistent cell populations preventing complete tumor eradication, potentially through surface marker-directed ADCs or radiopharmaceuticals. Pleural-based therapies represent another frontier, given recurrent pleural involvement in EGFR-mutant disease.

The panel presents individual sequencing strategies for EGFR-mutant advanced NSCLC. Dr. Camidge favors modified FLAURA-2 approaches, starting osimertinib monotherapy to establish patient relationships and toxicity tolerance before adding platinum-pemetrexed within 6 weeks unless contraindicated. Approximately 20% of his generally fit Denver population receives osimertinib monotherapy.

MET pathway involvement in EGFR resistance varies by initial treatment regimen. Dr. Devarakonda explains that MET amplification represents the most common known resistance mechanism following osimertinib-chemotherapy combinations, allowing EGFR blockade bypass.

The most challenging scenario involves patients who received frontline chemotherapy-osimertinib combinations and subsequently progress. Dr. Camidge reviews subgroup data from FLAURA-2 showing that approximately 70% of progressive patients received subsequent chemotherapy, with differences based on prior platinum exposure.

Following osimertinib monotherapy progression without CNS involvement, clinicians choose between COMPEL (continuing osimertinib plus chemotherapy) and MARIPOSA-2 (amivantamab plus chemotherapy without osimertinib continuation).

At disease progression, comprehensive tumor characterization becomes as important as initial diagnosis. Dr. Camidge argues against using regimens that don't require resistance mechanism identification, emphasizing that understanding heterogeneous resistance mechanisms guides optimal therapy selection.

TP53 mutations occur in over 50% of patients with EGFR-mutant lung cancer, representing a consistently negative prognostic factor. Dr. Rotow explains that TP53 mutations appear prominently on NGS reports, requiring clinicians to determine appropriate management strategies.

The FDA approval of subcutaneous amivantamab with monthly dosing represents a significant advancement in treatment convenience. Dr. Devarakonda emphasizes that while toxicity concerns shouldn't discourage effective regimen use, practical barriers including time and supportive care requirements make subcutaneous administration valuable.

Dr. Rotow discusses limitations of traditional CTCAE toxicity grading for capturing patient experiences with EGFR-targeted therapies. Although useful for discrete, measurable, and life-threatening toxicities, CTCAE poorly captures lower-grade effects like skin rash or fatigue that significantly impact quality of life over extended treatment periods.

The panel contrasts FLAURA-2 (osimertinib plus chemotherapy) with MARIPOSA (osimertinib plus amivantamab), acknowledging similar efficacy profiles with overall survival approaching four years in both regimens. However, significant differences exist in toxicity profiles and supportive care requirements.

Dr. Julia Rotow emphasizes shared decision-making as essential for frontline treatment selection, noting the dramatic shift from osimertinib monotherapy as standard to combination therapy as default over the past 2 to 3 years. Treatment decisions require balancing disease-associated risk factors with patient-specific considerations.

Dr. Benjamin Levy introduces an expert panel to discuss the increasingly complex landscape of EGFR-mutant advanced non-small cell lung cancer (NSCLC) treatment. The frontline setting now includes three viable options representing a significant shift from the previously straightforward osimertinib monotherapy approach.

Explore the evolving role of Trop-2 in non-small cell lung cancer and the importance of larger studies and biomarkers for future treatments.

Recent studies on Trop2-ADC reveal promising predictive biomarkers for lung cancer treatment, sparking excitement while urging caution for further research.

Discover the groundbreaking QCS method for measuring Trop-2 in lung cancer, enhancing accuracy and objectivity in biomarker assessment.

Exploring the complexities of Trop-2 expression in cancer, this discussion highlights challenges in measurement and its implications for treatment efficacy.

Explore the evolving role of Trop-2 in non-small cell lung cancer, including measurement techniques and emerging therapeutic insights.

Benjamin P. Levy, MD leads a live CFS discussion with Kamel Abou Hussein, MD and Victoria Rizk, MD on the evolving therapeutic landscape in breast cancer.

Benjamin P. Levy, MD, and Jonathan W. Lee, MD, MSc discuss advances in EGFR-Mutant, HER2-Positive, and Oncogene-Driven NSCLC Highlighted at CFS.

Drs Levy and Tagawa discuss the rapidly evolving treatment paradigms for prostate cancer and RCC live at the 43rd Annual Chemotherapy Foundation Symposium.

Lung cancer experts discuss successes and hesitations regarding the evolving use of antibody-drug conjugates in non–small cell lung cancer.

Panelists discuss how treatment decisions for advanced non–small cell lung cancer (NSCLC) without actionable mutations depend on factors like PD-L1 status, histology (eg, squamous [SQ]), and biomarkers like STK11/KEAP1. Chemotherapy may be added based on individual patient factors, with promising advancements expected in 2025.

Panelists discuss how emerging data on novel HER2-targeted agents, including Beamion LUNG-1 (zongertinib) and SOHO-1 (BAY 2927088), show promise for advanced non–small cell lung cancer (NSCLC). Additionally, the eNRGy trial and FDA approval of zenocutuzumab for NRG1 fusion–positive non–small cell lung cancer (NSCLC) offers new treatment avenues. Patient selection will depend on genetic profiling and treatment efficacy.