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Opinion|Videos|May 2, 2025

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

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

Panelists discuss how a 56-year-old patient with high-risk disease features was successfully treated with osimertinib plus chemotherapy, achieving excellent response before eventually discontinuing pemetrexed maintenance while continuing osimertinib.

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 1 – High Disease Burden

Main Discussion Topics:

Management of a 56-year-old never-smoker with high-burden metastatic disease
Treatment selection process considering multiple high-risk features
Response to therapy and subsequent maintenance decisions

Key Points for Physicians:

Patient presented with multiple high-risk features: high disease burden, brain metastases, TP53 mutation, liver metastases
FLAURA2 regimen (osimertinib + chemotherapy) was selected due to these factors and patient preference for longevity
Toxicity management included osimertinib dose reduction and growth factor support

Notable Insights:

After approximately 1 year of therapy with excellent response, the patient elected to discontinue pemetrexed maintenance due to quality-of-life concerns, while continuing osimertinib.

Clinical Significance:

This case illustrates the real-world application of risk-stratified treatment selection, toxicity management, and evolving treatment decisions based on response and patient preferences.

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