Dr. Ticiana Leal, professor and director of the Thoracic Program at the Winship Cancer Institute of Emory University, presents a single-expert discussion on treatment selection and sequencing for patients with EGFR-mutated advanced non-small cell lung cancer (NSCLC), focusing on data presented at ELCC 2026. The discussion covers frontline decision-making between osimertinib monotherapy, osimertinib plus chemotherapy (FLAURA2), and amivantamab plus lazertinib (MARIPOSA), with updated overall survival data favoring combination strategies for the majority of patients harboring high-risk features. Key topics include TP53 co-mutation and ctDNA-driven risk stratification, new TOP trial data, real-world toxicity management including the COCOON dermatologic prophylaxis strategy, the shift to subcutaneous amivantamab, time toxicity considerations, second-line sequencing including COMPEL, MARIPOSA-2, and datopotamab deruxtecan, chemotherapy rechallenge data from FLAURA2, and CNS and leptomeningeal disease management. Dr. Leal closes with anticipated developments in early-stage and perioperative EGFR-mutated NSCLC treatment.
Dr. Ticiana Leal introduces the discussion on treatment selection and sequencing in EGFR-mutated advanced non-small cell lung cancer (NSCLC), emphasizing that biomarker testing results must be available before initiating any frontline treatment discussion. With osimertinib monotherapy, osimertinib plus chemotherapy, and amivantamab plus lazertinib all now guideline-recommended, she reviews the comparative efficacy data driving patient discussions.
