Community Adoption of Frontline Combination Regimens and Tolerability

This segment turns from trial data to real-world practice, examining how quickly community oncology is adopting frontline combination regimens for EGFR-mutated NSCLC. Both osimertinib plus platinum-based chemotherapy (FLAURA2) and amivantamab plus lazertinib (MARIPOSA) are preferred options with survival benefit over osimertinib monotherapy. Familiarity with platinum and pemetrexed initially favored the chemotherapy-based combination, while comfort with amivantamab-lazertinib has grown alongside a subcutaneous formulation that lowers infusion-related reactions and chair time. For amivantamab-based therapy, a skin-toxicity regimen is reviewed, including a bland moisturizer, antibiotics for the scalp, and anticoagulation. For chemotherapy-based combinations, fatigue is a noted toxicity, and there is discussion about maintenance pemetrexed not necessarily being continued to full progression since osimertinib can maintain disease control, along with other strategies to maintain patient quality of life.