High-Risk Patient Populations and Therapy Selection for EGFR-Mutant mNSCLC
Oncologists discuss effective strategies for safely implementing combination therapies while managing adverse events to enhance patient outcomes.
In this segment, the panel focuses on identifying high-risk patient populations and determining optimal therapy strategies. Patients with high tumor burden, CNS or liver metastases, and specific molecular markers, such as p53 mutations, are emphasized as having worse prognoses and may benefit most from combination therapies. Experts highlight the importance of not de-escalating therapy based solely on the absence of these risk factors, as first-line combination strategies improve outcomes across all patient subgroups. The discussion introduces a framework for evaluating patient characteristics to guide therapy selection, emphasizing that clinical judgment must consider both objective measures, such as tumor burden, and subjective factors, such as patient tolerance and preferences. The segment addresses the “marathon” concept of EGFR therapy, framing treatment as a long-term strategy rather than a short-term sprint. Panelists discuss balancing efficacy and tolerability to optimize first-line outcomes, with careful monitoring to adjust therapy based on response and side effects. The panelists also touch on fallback strategies and future sequencing, noting that options after first-line combination therapy are limited, reinforcing the importance of initiating optimal therapy at the outset. Overall, this segment provides a comprehensive overview of patient assessment and therapeutic decision-making in high-risk populations.
