Non-Small Cell Lung Cancer (NSCLC)

Treatment with lorlatinib might be effective regardless of the presence of central nervous system metastases, according to Misako Nagasaka, MD, PhD.

Most central nervous system events with lorlatinib were grade 1 or 2 in the phase 3 CROWN trial.

Treatment with lorlatinib did not increase cardiovascular events among patients with ALK-positive non–small cell lung cancer in the CROWN trial.

At 5 years, 60% of patients who received lorlatinib in the phase 3 CROWN study achieved progression-free survival.

Panelists discuss how the standardized COCOON regimen offers clear guidance for managing dermatologic adverse effects, with specific components such as clindamycin lotion for the scalp and chlorhexidine wash for nails showing effectiveness.

Panelists discuss how patients have been receptive to the proactive management approach that effectively reduces dermatologic adverse effects, despite initial concerns about adding multiple prophylactic interventions.

Ongoing ctDNA analysis may elucidate outcomes associated with divarasib plus migoprotafib for those with KRAS G12C–positive NSCLC.

Panelists discuss how overcoming resistance mechanisms in EGFR-mutated non–small cell lung cancer (NSCLC) remains a key unmet need, with future research focusing on targeting these mechanisms, exploring new drug combinations, and optimizing treatment sequences to improve patient outcomes.

Panelists discuss how the adverse effect profile of amivantamab plus lazertinib (ami-laz) compares with other combination therapies, emphasizing its balance between therapeutic efficacy and quality of life, and how this influences decision-making in treatment selection.

Panelists discuss how the COCOON dermatologic management protocol significantly reduced grade 2 or higher dermatologic adverse events in multiple locations, particularly on the face/body (23% vs 62%), scalp (9% vs 29%), and nails (16% vs 21%).

Panelists discuss how the baseline characteristics of patients in the COCOON trial were evenly matched, with slightly more women than men and a significant number of Asian patients, which is typical for EGFR-mutant non–small cell lung cancer.

Panelists discuss how targeted cancer therapies, particularly those affecting the EGFR and c-MET receptors, present unique adverse effects such as dermatologic reactions and venous thromboembolism, emphasizing the importance of proactive management, patient education, and evolving treatment strategies to balance efficacy with quality of life.

Panelists discuss how intracranial progression-free survival (PFS) and duration of response (DoR) influence treatment decisions, highlighting the significance of intracranial data in differentiating this regimen within the treatment landscape, its potential impact on brain metastases management, and the role of radiation therapy in clinical practice.

The phase 3 HARMONi-6 trial found invonescimab plus chemotherapy improved PFS vs tislelizumab plus chemotherapy in squamous NSCLC.

Panelists discuss how the COCOON trial demonstrated that enhanced dermatologic management significantly reduced grade 2 or higher skin-related adverse events (38% vs 76%) compared with standard of care for patients receiving amivantamab plus lazertinib.

Panelists discuss how amivantamab plus lazertinib therapy for EGFR-mutant non–small cell lung cancer has shown promising survival data while highlighting the importance of managing adverse events for improved quality of life.

In first-line, EGFR-mutated NSCLC, targeted therapies such as osimertinib or amivantamab plus lazertinib are recommended.

A 5-year follow-up of the phase 3 EMPOWER-Lung 1 showed the greatest survival benefits in patients with NSCLC who have a PD-L1 expression of 90% or more.

Pooled results from the TRUST-I and TRUST-II trials showed that taletrectinib led to infrequent neurological TEAEs in patients with ROS1-positive NSCLC.

Panelists discuss how the growing role of combination therapies in EGFR-mutated non–small cell lung cancer (NSCLC) influences the choice between the MARIPOSA and FLAURA2 trials, considering overall survival data, multidisciplinary implementation, patient education, and their impact on first-line prescribing decisions.

Panelists discuss how both chemotherapy-free and chemotherapy-containing combinations offer valuable treatment options for first-line EGFR-mutated non–small cell lung cancer (NSCLC) patients, with considerations including survival benefits, brain metastasis concerns, adverse effect profiles, and the evolution toward personalized treatment selection rather than viewing either approach as universally superior.

Phase 3 CROWN trial findings suggest that patients with ALK-positive NSCLC may maintain efficacy even after reducing lorlatinib dosing to mitigate AEs.

A disease-free survival and minimal residual disease event-free status was maintained for most patients with adjuvant osimertinib for EGFR-mutant NSCLC.

Panelists discuss how the significant overall survival (OS) benefit demonstrated by the new combination therapy (amivantamab-lazertinib) compared with standard monotherapy makes it a preferred treatment option for most patients despite a slightly increased toxicity and time commitment.

Patients with ALK-positive NSCLC not vulnerable to neurological adverse effects or prone to weight issues, might benefit from treatment with lorlatinib.