Navigating EGFR-Mutated NSCLC: Clinical Insights for Pharmacists on Personalized Care
Cara Chang, PharmD, BCOP, provides comprehensive insights into the challenges, advances, and best practices in treating EGFR-positive non–small cell lung cancer (NSCLC), emphasizing the importance of molecular testing before treatment initiation, the evolution of targeted therapies and combination approaches, the critical role of pharmacists in medication management and patient education, and emerging treatments including subcutaneous amivantamab and antibody-drug conjugates that promise to improve outcomes while reducing toxicity.
EP. 1: Overcoming Challenges in NSCLC Management From a Pharmacist’s Perspective
April 18th 2025A panelist discusses how non–small cell lung cancer presents significant treatment challenges due to its prevalence, high mortality rate, poor 5-year survival outcomes, and the difficulty of managing patients with advanced disease who often have poor performance status and multiple metastases, emphasizing the importance of pharmacist involvement for proper dosing, growth factor support, and comprehensive patient education about chemotherapy.
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EP. 2: First-Line Focus: Molecular Testing and Guideline-Directed Therapy in EGFR-Positive NSCLC
April 18th 2025A panelist discusses how waiting for molecular testing results before initiating treatment for non–small cell lung cancer (NSCLC) is crucial because patients with EGFR mutations can avoid chemotherapy and immunotherapy in favor of targeted oral agents like osimertinib, which offer survival benefits with minimal toxicity compared to traditional treatments, while premature immunotherapy could cause severe immune-related adverse events that might preclude later use of more appropriate targeted therapies.
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EP. 3: Recent Clinical Trial Highlights for NSCLC Treatment
April 25th 2025A panelist discusses how recent clinical trials for EGFR-positive non–small cell lung cancer (NSCLC) have expanded treatment options beyond single oral agents, with studies like FLAURA2, MARIPOSA, and PAPILLON demonstrating significant improvements in progression-free survival for combination therapies such as osimertinib plus chemotherapy and amivantamab plus lazertinib, though these combinations often come with higher rates of toxicity, discontinuation, and adverse effects compared to monotherapies.
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EP. 4: Integrating Clinical Trial Findings Into Everyday Pharmacy Practice
April 25th 2025A panelist discusses how combining therapies for EGFR-positive non–small cell lung cancer (NSCLC) increases both benefits (improved progression-free survival, response rates, and duration of response) and adverse effects, emphasizing that treatment selection should consider patient-specific factors like central nervous system (CNS) metastases, performance status, treatment aggressiveness preferences, and real-world limitations where patients often differ from clinical trial populations in terms of organ dysfunction, concomitant medications, and previous treatments.
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