Julia Rotow, MD, is a physician, clinical director of the Lowe Center for Thoracic Oncology, and director of Clinical Research at Dana-Farber Cancer Institute, as well as an assistant professor of medicine at Harvard Medical School.
Panelists discuss how, if the MARIPOSA trial shows an overall survival advantage exceeding 1 year, the amivantamab-lazertinib combination may see increased frontline use. Subsequent therapy options could include chemotherapy, targeted therapies based on resistance mechanisms, or clinical trials for emerging treatments.
Panelists discuss how medical professionals consider continuing osimertinib with second-line and subsequent therapies based on disease progression, resistance mechanisms, and patient response. It may be combined with other agents or switched depending on clinical trials, biomarkers, and overall treatment goals to optimize outcomes.
Panelists discuss how medical professionals balance maximizing progression-free survival with preserving future treatment options by considering disease biology, resistance mechanisms, and patient factors. At first progression, the NCCN recommends continuing current therapy or switching to amivantamab with a platinum doublet, based on mutation status, prior response, toxicity, and patient preferences.
Panelists discuss how medical professionals use shared decision-making by aligning treatment options with patient values, discussing benefits, risks, and preferences. Patients often prioritize longest progression-free survival (PFS), lowest toxicity, and shortest infusion time. Collaborative discussions ensure personalized, evidence-based care.
Panelists discuss how disease-related factors like central nervous system (CNS) involvement or specific metastatic sites can guide treatment selection, favoring agents with CNS penetration or targeted efficacy. Mutational factors, such as TP53 comutations, may impact therapy response. Patient-related aspects, including age and comorbidities, influence tolerability and regimen choice.
Panelists discuss how, when discussing frontline regimens for EGFR-mutated non–small cell lung cancer (NSCLC), the NCCN-recommended options include osimertinib monotherapy for its targeted approach with lower toxicity; amivantamab/lazertinib combination for potentially deeper responses in specific mutations; and osimertinib with platinum-doublet chemotherapy for more aggressive disease requiring enhanced tumor control.
Panelists discuss how they currently utilize emerging ctDNA platforms for high-risk patients and explore whether these advancements will soon become standard practice in clinical decision-making.
Panelists discuss how the field aims to translate lessons learned from metastatic treatment into earlier-stage interventions for select patients, sharing their current practices and hopes for future advancements in care.
Panelists discuss how recent insights into delayed resistance mechanisms in EGFR-positive cancers, including the role of combination therapies and improved testing methods, are shaping strategies to better manage and overcome resistance.
Panelists discuss how advancements in targeted therapies and personalized medicine are crucial for addressing the pressing unanswered questions in the management of ALK-positive and BRAF-positive cancers.
Panelists discuss the role of immunotherapy in the treatment landscape for BRAF-positive NSCLC, considering factors influencing the choice between immunotherapy and targeted therapy, emerging therapies, ongoing clinical trials, and approaches to dosing, sequencing, and toxicity management for both ALK and BRAF inhibitors.
Panelists discuss recent data on progression-free survival (PFS) and duration of response (DOR) for BRAF-MEK inhibitor combinations, including encorafenib + binimetinib and dabrafenib + trametinib, while also addressing emerging safety signals, differences in response based on treatment lines, and considerations for dose modifications and sequencing strategies in clinical practice.
Panelists discuss their insights on current and emerging combination strategies in the treatment of BRAF-positive NSCLC, focusing on the integration of targeted therapies, immunotherapies, or both.
Panelists discuss the findings from the ALINA study on adjuvant alectinib vs chemotherapy in resected ALK-positive NSCLC, considering how these results may influence early-stage management, sequencing strategies for ALK inhibitors, and the role of resistance mechanisms in treatment decisions.
Panelists discuss the efficacy of ALK inhibitors in treating brain metastases, referencing data from the REMARK study, the CROWN trial, ALTA-3, and ALTA-1L/brigatinib, among others.
Panelists discuss the circumstances under which they would consider switching patients on different first-line treatments to lorlatinib and outline approaches for CNS surveillance and management in ALK-positive patients.
Panelists discuss how recent data influence treatment choices for ALK-positive NSCLC patients, highlighting specific patient factors that guide decisions and potential concerns regarding the use of lorlatinib as first-line therapy.
Panelists discuss the key findings from the latest data from the CROWN and BRIGHTSTAR studies, emphasizing efficacy end points and comparing the effectiveness of these regimens with that of others in the treatment landscape for ALK-positive NSCLC.
Panelists discuss the importance of molecular testing in NSCLC, particularly for ALK rearrangements, and explore how recent advancements and emerging technologies are shaping first-line treatment selection for ALK-positive patients.
The panel examines which patient populations might benefit most from treatment with datopotamab deruxtecan (Dato-DXd), sacituzumab govitecan, and patritumab deruxtecan (HER3-DXd). Additionally, they explore potential sequencing strategies for these antibody-drug conjugates in second-line and later treatment settings.
Benjamin Levy, MD, compares the common toxicities associated with datopotamab deruxtecan (Dato-DXd), sacituzumab govitecan, and patritumab deruxtecan (HER3-DXd), and shares practical tips for managing these toxicities in the clinical setting to optimize patient care and minimize adverse effects.
Julia Rotow, MD, highlights and discusses other notable antibody-drug conjugate (ADC) data presented at the American Society of Clinical Oncology (ASCO) 2024 annual meeting, providing insights into the potential impact of these findings on the evolving treatment landscape for non-small cell lung cancer (NSCLC).
Dr Rotow discusses data that demonstrated the central nervous system activity of datopotamab deruxtecan and osimertinib in patients with NSCLC.
Benjamin Levy, MD, provides an overview of the rationale and study design for the EVOKE-01 trial, which evaluates the efficacy and safety of sacituzumab govitecan in patients with non-small cell lung cancer who have experienced disease progression following treatment with platinum-based chemotherapy and checkpoint inhibitors.
Helena A. Yu, MD, initiates a discussion on the role of HER3 in the development of resistance to EGFR-targeted therapies. She also examines the HERTHENA-Lung01 study and analyzes the emerging data from this trial.
Julia Rotow, MD, discusses the importance of comprehensive biomarker testing for all patients with NSCLC.
The panel explores promising novel therapies in the treatment landscape, focusing on new or recently presented data at the American Society of Clinical Oncology (ASCO) 2024 annual meeting, and share their insights on the potential impact of these therapies on future clinical practice.
Helena A. Yu, MD, examines the patient selection criteria for potentially using osimertinib monotherapy, osimertinib plus chemotherapy, or amivantamab combined with lazertinib in the first-line treatment of advanced EGFR-mutant non-small cell lung cancer.
