First 4 Months of Monitoring and Dose Interruptions

Edgardo Santos, MD, FACP, FASCO, of Starling Oncology, describes how he follows patients through the first months of subcutaneous amivantamab plus lazertinib for EGFR-mutated advanced non–small cell lung cancer. He tells Wade Iams, MD, MSCI, of Tennessee Oncology, that he sees patients weekly early on, reinforces sun protection and every component of the prophylaxis regimen, and asks patients to call at the first sign of rash so the team can intervene quickly. Depending on grade, he holds amivantamab, or both drugs, continuing lazertinib where appropriate and noting that lazertinib is a third-generation tyrosine kinase inhibitor, so the patient is not left without therapy. Dr Santos cites an analysis of MARIPOSA showing that most toxicity occurs within the first 4 months and that patients who interrupted treatment during that window had no difference in progression-free survival compared with those who did not. Dr Iams calls the analysis reassuring.