CNS Disease and Intracranial Management in EGFR-Mutant mNSCLC

EP: 1.Introduction and Emerging Therapies for EGFR-Mutant mNSCLC

EP: 2.Clinical Trial Data Overview

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EP: 3.CNS Disease and Intracranial Management in EGFR-Mutant mNSCLC

EP: 4.High-Risk Patient Populations and Therapy Selection for EGFR-Mutant mNSCLC

Panelists discuss the management of CNS disease in patients with EGFR-mutant mNSCLC. They highlight that many high-risk patients are asymptomatic despite having brain metastases, which presents challenges in early detection and treatment planning. CNS imaging is emphasized as an essential tool for monitoring disease progression and treatment response, particularly in patients receiving systemic combination therapies. The experts compare different trial approaches, noting that MARIPOSA included routine baseline and follow-up CNS imaging, whereas FLAURA did not, which impacts the ability to assess true intracranial efficacy. Data show that combination therapy with amivantamab and lazertinib not only improves intracranial progression-free survival but also stabilizes the tail of the survival curve over time, providing durable disease control in the CNS. The segment also discusses practical monitoring strategies, including the timing of follow-up MRI scans to ensure effective disease management. Adverse event considerations are addressed, emphasizing the importance of patient education and proactive management to maintain quality of life. This discussion underscores the evolving standard of care for patients with CNS involvement and reinforces the need for aggressive, targeted treatment approaches early in therapy.