Measuring Impact: Observed Differences in Dermatologic AEs Between COCOON Protocol and Standard Approaches

EP: 1.Clinical Insights: Experiences With Amivantamab-Lazertinib in EGFR-Mutant NSCLC

EP: 2.Overview of Study Design of the COCOON Trial

EP: 3.COCOON Baseline Characteristics

EP: 4.COCOON: Discussion of Clinical End Points and Dose Modifications

EP: 5.Initial Reactions to COCOON Study’s Dermatologic/Nail AE Reductions

EP: 6.Clinician Experiences: COCOON Regimen vs Traditional SoC AE Management

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EP: 7.Measuring Impact: Observed Differences in Dermatologic AEs Between COCOON Protocol and Standard Approaches

EP: 8.Building Support Systems: Resources and Multidisciplinary Collaboration for Optimizing COCOON Implementation

EP: 9.Operational Considerations: Workflow Adjustments and Monitoring Systems for Effective COCOON Implementation

EP: 10.COCOON in Practice: Patient Preparation, Key Insights, and Implementation Best Practices

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Dermatologic Adverse Event Management for Amivantamab Patients

Current Monitoring Practices

The panelists have established a proactive approach to monitoring dermatologic adverse events in patients receiving amivantamab:

• Visual assessment of patients during regular biweekly treatment visits
• Direct patient education about potential dermatologic toxicities including:

Rashes

• Nail changes

• Scalp lesions/scabs

Patient Communication Strategy

• Up-front education: Patients are explicitly informed at the beginning of treatment about potential dermatologic adverse effects.
• Self-monitoring instructions: Patients are advised to:
• Check their scalp multiple times weekly

• Be attentive to bodily changes

• Report any dermatologic issues immediately
• Digital communication methods: Although formal digital tools are limited, clinicians encourage:
• Email or text message communication

• Sending photos of concerning areas

Clinical Rationale

This monitoring approach is implemented for several important reasons:

• Quality of life preservation: Dermatologic adverse effects can significantly impact patient well-being
• Treatment adherence: Better adverse effect management leads to improved protocol adherence
• Avoiding treatment interruptions: Early intervention may prevent the need for:
• Treatment holds

• Dose reductions

Challenges Noted

A common issue is delayed reporting by patients, with examples of:

• Patients enduring symptoms for extended periods (up to 6 months) before reporting
• Waiting until symptoms become severe before seeking intervention

Intervention Philosophy

The clinicians emphasize that earlier intervention is preferable to delayed management, with the hope that prophylactic approaches will reduce overall toxicity burden.