Has Combination Therapy Become the New Frontline Treatment Standard for EGFR-Mutant Metastatic NSCLC?

EP: 1.The Evolution of EGFR-Mutated Advanced NSCLC Treatment: Present Considerations and Future Treatment Options

Now Viewing

EP: 2.Has Combination Therapy Become the New Frontline Treatment Standard for EGFR-Mutant Metastatic NSCLC?

EP: 3.Decision Points to Consider When Choosing Treatment With Monotherapy or Combination Therapy for EGFR-Mutant mNSCLC

EP: 4.Evaluating Patient Preferences for the Treatment of EGFR-Mutant mNSCLC

EP: 5.Comparing the Combination Therapies for the Treatment of EGFR-Mutant mNSCLC

EP: 6.Considering Resistance Mechanisms When Choosing Therapy in the Frontline Setting

EP: 7.The Importance of Maintaining Quality of Life and Intervening Early When Adverse Events Occur in the Frontline Treatment Setting

EP: 8.Weighing the 1-Year Projected Overall Survival Benefit With MARIPOSA in the Frontline Treatment of EGFR-Mutant mNSCLC

EP: 9.Discussing the Time and Financial Toxicities Associated With Combination Therapies and Potential Mitigation Strategies

EP: 10.Discussing Potential Combination Therapy Medication-Associated Toxicities With Patients

EP: 11.Evaluating the Clinical Utility of Subcutaneous Amivantamab in the Treatment of EGFR-Mutant mNSCLC

EP: 12.The Importance of Multidisciplinary Collaboration With Subspecialty Physicians in the Toxicity Management With Treatment

EP: 13.Exploring Second-Line Treatment Options Including Targeted Radiation and Surgery for the Management of EGFR-Mutant mNSCLC

EP: 14.Tissue vs Plasma Biopsy After First Disease Progression in EGFR-Mutant NSCLC

EP: 15.Deciding Between a Biomarker-Directed Approach and a Biomarker-Agnostic Approach for Second-Line Treatment of EGFR-Mutant NSCLC

EP: 16.Continuing the Targeted TKI in the Second Line for the Treatment of EGFR-Mutant NSCLC

EP: 17.When to Consider Retreatment With Chemotherapy After FLAURA2 for EGFR-Mutant NSCLC

EP: 18.Patient Case Presentation: A 45-Year-Old With Newly Diagnosed EGFR-Mutant mNSCLC and Liver Metastases

EP: 19.Patient Case Presentation: A 69-Year-Old With Newly Diagnosed EGFR-Mutant mNSCLC and Symptomatic Brain Metastases

This cancer network program focuses on combination therapy as an emerging frontline treatment standard for EGFR-mutant metastatic non–small cell lung cancer (NSCLC). The panel discussion features thoracic medical oncologists and advanced practice providers from leading cancer centers including the University of Maryland, Duke University, Maryland Oncology Hematology, and Johns Hopkins. The program aims to examine the evolving treatment landscape for advanced EGFR-mutated NSCLC, specifically addressing new combination treatment options for newly diagnosed patients and their impact on clinical outcomes.

The discussion centers on whether combination therapies—specifically osimertinib plus chemotherapy or amivantamab plus lazertinib—have become the preferred standard of care over single-agent osimertinib monotherapy. One panelist emphasizes that recent advances demonstrate both combinations are superior to monotherapy, particularly for progression-free survival. The approach of using “strongest sauce first” is advocated, drawing parallels to treatment strategies in other cancers where the most aggressive therapy is typically administered up front for optimal overall outcomes.

However, the panel reveals a nuanced approach to treatment selection, noting that there isn’t a universally preferred frontline regimen. Treatment recommendations are highly individualized based on patient clinical characteristics and next-generation sequencing results. Single-agent osimertinib remains preferred for patients with low disease burden, asymptomatic central nervous system (CNS) metastases, multiple medical comorbidities who may not tolerate chemotherapy, and those who prioritize quality of life with oral agent convenience. The decision-making process involves thorough patient discussions about different options, risks, benefits, and adverse effect profiles. High-risk features like CNS involvement and co-occurring genomic alterations guide clinicians toward combination therapy, making this one of the more complex treatment decisions in oncology practice.