Monotherapy Use Cases and Future Directions in EGFR-Mutant NSCLC

The final episode outlines scenarios where osimertinib monotherapy remains appropriate: older patients with substantial comorbidities, low-volume disease, malignant effusion as the sole metastatic site, or strong preferences for minimal clinic time and maximum travel flexibility. While combinations generally offer superior long-term outcomes, a well-tolerated single-agent approach can deliver meaningful benefit in these profiles, with the option to escalate later, recognizing that some patients may never reach later-line therapy. Operational systems for toxicity management are then described, including early, scheduled nurse check-ins; explicit symptom call thresholds; rapid triage; and access to dermatology for refractory or complex skin events. The discussion concludes with forward-looking priorities: dissecting resistance mechanisms by frontline regimen, ensuring next-line agents retain CNS activity, and integrating emerging targeted strategies such as next-generation bispecific antibodies. The program closes by summarizing practical takeaways on regimen selection, CNS management, toxicity systems, and the overarching need to individualize care.