Treatment Strategies Following Progression in EGFR-Mutant NSCLC

This segment examines treatment approaches following disease progression in EGFR-mutant non-small cell lung cancer (NSCLC), with a focus on the role of continuing osimertinib beyond progression. Dr. Mark Socinski and Dr. Susan Scott discuss findings from the COMPEL trial and how these data have influenced their clinical practice. Dr. Scott explains that when transitioning to platinum-based chemotherapy, she often continues osimertinib, particularly in patients with limited sites of progression or ongoing clinical benefit, including maintenance of central nervous system (CNS) disease control. The discussion highlights the biological heterogeneity of disease progression, emphasizing that not all metastatic lesions develop resistance simultaneously. Although acknowledging the limitations of the relatively small COMPEL study, both experts note that its progression-free survival findings and CNS outcomes provide reassurance for continuing EGFR-targeted therapy in selected patients. They also emphasize the need for continued research to further define optimal sequencing strategies after frontline osimertinib.