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Opinion|Videos|May 2, 2025

45-Year-Old Never-Smoker with Advanced EGFR-Mutant NSCLC and CNS Metastases Treated with the MARIPOSA Regimen

Author(s)Helena A. Yu, MD, Linda Ahn, MSN, ANP-BC, AOCNP

Panelists discuss how a 45-year-old anxious patient who refused chemotherapy was successfully treated with amivantamab plus lazertinib along with prophylactic management strategies for potential adverse effects.

Episodes in this series

2 experts are featured in this series.

EP. 1 EGFR-Mutant NSCLC: Navigating an Increasingly Complex Treatment Landscape

2 experts are featured in this series.

EP. 2 MARIPOSA OS Data: Shaping Frontline Treatment in EGFR-Mutant NSCLC

2 experts are featured in this series.

EP. 3 Overall Survival as a Driver of 1L EGFRm NSCLC Treatment Selection

2 experts are featured in this series.

EP. 4 Understanding OS Through 2 Lenses: Patients and Providers in EGFRm NSCLC

2 experts are featured in this series.

EP. 5 Balancing Survival and Quality of Life in 1L EGFRm NSCLC Treatment Decisions

2 experts are featured in this series.

EP. 6 Translating OS Data Into Patient Conversations: Balancing Benefit and Burden

2 experts are featured in this series.

EP. 7 Balancing Clinical and Patient-Centered Factors in 1L EGFRm NSCLC Treatment

2 experts are featured in this series.

EP. 8 Impact of Disease Characteristics on 1L Treatment Decisions in EGFRm NSCLC

2 experts are featured in this series.

EP. 9 Weighing QoL and Toxicity in 1L EGFRm NSCLC Treatment Decisions

2 experts are featured in this series.

EP. 10 FLAURA2 Maintenance: Key Strategies for Treatment Optimization and Patient Monitoring

2 experts are featured in this series.

EP. 11 Evaluating Pemetrexed Exposure in FLAURA2: Key Findings and Treatment Implications

2 experts are featured in this series.

EP. 12 56-Year-Old Never-Smoker Female with High-Risk Metastatic EGFR-Mutant NSCLC Treated with the FLAURA2 Regimen

2 experts are featured in this series.

EP. 13 45-Year-Old Never-Smoker with Advanced EGFR-Mutant NSCLC and CNS Metastases Treated with the MARIPOSA Regimen

2 experts are featured in this series.

EP. 14 Looking Ahead: Unmet Needs and Future Directions in the Treatment of Advanced EGFR-Mutant NSCLC

Case Presentation 2 – Patient With Treatment Preferences

Main Discussion Topics:

Management of a 45-year-old preschool teacher with significant anxiety about treatment
Addressing a patient’s strong preference against chemotherapy
Implementation of prophylactic strategies for adverse event management

Key Points for Physicians:

Patient with EGFR exon 21 mutation, numerous brain metastases, and adamant preference against chemotherapy
Amivantamab + lazertinib selected as a chemotherapy-free option with demonstrated overall survival and central nervous system (CNS) benefits
Comprehensive prophylactic measures implemented (dexamethasone premedication, skin prophylaxis, anticoagulation)

Notable Insights:

Patient education involved balancing data-driven information about efficacy with counseling about expected toxicities and management strategies.

Clinical Significance:

This case demonstrates how treatment selection can be successfully tailored to align with patient preferences while still providing optimal efficacy for high-risk disease features.

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