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Opinion|Videos|May 2, 2025

Weighing QoL and Toxicity in 1L EGFRm NSCLC Treatment Decisions

Author(s)Helena A. Yu, MD, Linda Ahn, MSN, ANP-BC, AOCNP

Panelists discuss how quality-of-life (QoL) considerations and individual toxicity profiles significantly impact first-line (1L) treatment decisions, with different regimens having distinct adverse effect profiles.

Episodes in this series

2 experts are featured in this series.

EP. 1 EGFR-Mutant NSCLC: Navigating an Increasingly Complex Treatment Landscape

2 experts are featured in this series.

EP. 2 MARIPOSA OS Data: Shaping Frontline Treatment in EGFR-Mutant NSCLC

2 experts are featured in this series.

EP. 3 Overall Survival as a Driver of 1L EGFRm NSCLC Treatment Selection

2 experts are featured in this series.

EP. 4 Understanding OS Through 2 Lenses: Patients and Providers in EGFRm NSCLC

2 experts are featured in this series.

EP. 5 Balancing Survival and Quality of Life in 1L EGFRm NSCLC Treatment Decisions

2 experts are featured in this series.

EP. 6 Translating OS Data Into Patient Conversations: Balancing Benefit and Burden

2 experts are featured in this series.

EP. 7 Balancing Clinical and Patient-Centered Factors in 1L EGFRm NSCLC Treatment

2 experts are featured in this series.

EP. 8 Impact of Disease Characteristics on 1L Treatment Decisions in EGFRm NSCLC

2 experts are featured in this series.

EP. 9 Weighing QoL and Toxicity in 1L EGFRm NSCLC Treatment Decisions

2 experts are featured in this series.

EP. 10 FLAURA2 Maintenance: Key Strategies for Treatment Optimization and Patient Monitoring

2 experts are featured in this series.

EP. 11 Evaluating Pemetrexed Exposure in FLAURA2: Key Findings and Treatment Implications

2 experts are featured in this series.

EP. 12 56-Year-Old Never-Smoker Female with High-Risk Metastatic EGFR-Mutant NSCLC Treated with the FLAURA2 Regimen

2 experts are featured in this series.

EP. 13 45-Year-Old Never-Smoker with Advanced EGFR-Mutant NSCLC and CNS Metastases Treated with the MARIPOSA Regimen

2 experts are featured in this series.

EP. 14 Looking Ahead: Unmet Needs and Future Directions in the Treatment of Advanced EGFR-Mutant NSCLC

Quality-of-Life and Toxicity Considerations

Main Discussion Topics:

Comparative toxicity profiles of available treatment regimens
Impact of adverse effects on patient QoL
Prophylactic strategies to mitigate treatment-related adverse events

Key Points for Physicians:

Osimertinib monotherapy is extremely well tolerated with minimal impact on daily life
FLAURA2 (chemotherapy + osimertinib) has more intensive induction followed by manageable maintenance
Amivantamab + lazertinib has unique toxicities, including scalp rash, paronychia, hypoalbuminemia, and venous thromboembolism risk

Notable Insights:

Prophylactic strategies (COCOON for dermatologic toxicities; SKIPPirr for infusion reactions, anticoagulation) can significantly reduce adverse events with amivantamab/lazertinib.

Clinical Significance:

Selection of therapy requires careful assessment of toxicity profiles in the context of patient comorbidities, support systems, and preferences regarding appearance and lifestyle impact.

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