Benjamin P. Levy, MD

Benjamin P. Levy, MD, of Johns Hopkins University School of Medicine

Benjamin P. Levy, MD, is clinical director of Medical Oncology at Johns Hopkins Sidney Kimmel Cancer Center at Sibley Memorial Hospital and associate professor of oncology at Johns Hopkins University School of Medicine.

Articles by Benjamin P. Levy, MD

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.

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.

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.

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.

2 experts in this video

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.

2 experts in this video

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

2 experts in this video

Panelists discuss how the 5-year follow-up data from the CROWN trial support lorlatinib as a frontline treatment for ALK-positive non–small cell lung cancer NSCLC with brain metastasis. For frontline therapy, starting at full dose is preferred, adjusting if needed. Post progression, lorlatinib can be continued or combined with other agents. Biomarker testing for ROS1 is essential, with recent data (TRIDENT-1 trial) favoring lorlatinib for ROS1-positive central nervous system (CNS) involvement. Novel agents like taletrectinib and zidesamtinib from TRUST-I/II and ARROS-1 trials show promise in expanding treatment options for ROS1-positive NSCLC.

2 experts in this video

Panelists discuss how MARIPOSA-2 (Popat S, et al, ESMO 2024) and the September 2024 FDA approval of amivantamab plus chemo as a second-line option highlight advances in non–small cell lung cancer (NSCLC) treatment. Strategies involve sequencing with emerging therapies like HERTHENA-Lung01, addressing resistance, and central nervous system (CNS) metastases. The complete response letter (CRL) for HER3-DXd and the shift in biologics license application (BLA) status for Dato-DXd from TROPION-Lung05 (Lisberg A, et al, ASCO 2024) will shape clinical practices and resistance management moving forward.

2 experts in this video

Panelists discuss how the 5-year follow-up data from the CROWN trial support lorlatinib as a frontline treatment for ALK-positive non–small cell lung cancer NSCLC with brain metastasis. For frontline therapy, starting at full dose is preferred, adjusting if needed. Post progression, lorlatinib can be continued or combined with other agents. Biomarker testing for ROS1 is essential, with recent data (TRIDENT-1 trial) favoring lorlatinib for ROS1-positive central nervous system (CNS) involvement. Novel agents like taletrectinib and zidesamtinib from TRUST-I/II and ARROS-1 trials show promise in expanding treatment options for ROS1-positive NSCLC.

2 experts in this video

Panelists discuss how MARIPOSA-2 (Popat S, et al, ESMO 2024) and the September 2024 FDA approval of amivantamab plus chemo as a second-line option highlight advances in non–small cell lung cancer (NSCLC) treatment. Strategies involve sequencing with emerging therapies like HERTHENA-Lung01, addressing resistance, and central nervous system (CNS) metastases. The complete response letter (CRL) for HER3-DXd and the shift in biologics license application (BLA) status for Dato-DXd from TROPION-Lung05 (Lisberg A, et al, ASCO 2024) will shape clinical practices and resistance management moving forward.

2 experts in this video

Panelists discuss how the MARIPOSA trial (ASCO 2024) showed improved overall survival (OS) with amivantamab plus lazertinib vs osimertinib in first-line EGFR-mutant non–small cell lung cancer (NSCLC), supporting its FDA approval (October 2024). This regimen may become standard of care for select patients, but osimertinib with or without chemo remains vital. The complete response letter (CRL) for subcutaneous amivantamab may delay uptake.