Reinforcing Prophylaxis Adherence and Choosing Frontline Therapy

Wade Iams, MD, MSCI, of Tennessee Oncology, explains how his team keeps patients on prophylactic strategies when starting subcutaneous amivantamab plus lazertinib for EGFR-mutated advanced non–small cell lung cancer: repeated touches from multiple members of the care team over time, including his own counseling, nursing education at the injection visit, a call from a specialty pharmacist for the oral agent, and follow-up by advanced practice providers. He adds that patient anecdotes about rash often persuade more than instructions do. Closing the discussion with Edgardo Santos, MD, FACP, FASCO, of Starling Oncology, Dr Iams says overall survival matters most, and that 2 combination regimens improve it: amivantamab plus lazertinib, and platinum-based chemotherapy plus osimertinib in FLAURA2. From there his choice turns on the individual toxicity profile, how much a severe facial or scalp rash would affect quality of life, visit frequency, and whether a chemotherapy-free option is preferred.