Multidisciplinary Toxicity Management in EGFR-Mutated NSCLC

This segment centers on pneumonitis as the toxicity of greatest concern in EGFR-mutated advanced non-small cell lung cancer, both because dyspnea and imaging findings are hard to separate from progression and because a drug-induced diagnosis means stopping a therapy that may be working, sometimes alongside oxygen and prolonged steroids. Also covered is the practical bottleneck of reaching dermatology for scalp rash and paronychia, or ophthalmology for the ocular toxicities seen with antibody-drug conjugates, access that is more reliable in academic centers than in the community. Medical oncologists increasingly manage problems outside their formal training, which argues for shifting from reactive to prophylactic care along the lines of the COCOON and SKIPPirr approaches, while acknowledging that an extended antibiotic course plus topical regimens asks a lot of patients. Setting realistic expectations before treatment begins is emphasized throughout.