Recent Clinical Trial Highlights for NSCLC Treatment

EP: 1.Overcoming Challenges in NSCLC Management From a Pharmacist’s Perspective

EP: 2.First-Line Focus: Molecular Testing and Guideline-Directed Therapy in EGFR-Positive NSCLC

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EP: 3.Recent Clinical Trial Highlights for NSCLC Treatment

EP: 4.Integrating Clinical Trial Findings Into Everyday Pharmacy Practice

EP: 5.Barriers to Bridging Clinical Trial Data to Routine Pharmacy Practice

EP: 6.Enhancing Patient Care Through Multidisciplinary Team Collaboration in Management of NSCLC

EP: 7.Breaking New Ground: Emerging Therapies for Treatment of EGFR-Positive NSCLC

EP: 8.Balancing Treatment and Quality of Life: Adverse Events of First-Line Agents in NSCLC

EP: 9.Strategies to Minimize Toxicities, and the Pharmacist’s Role in Educating and Supporting Patients With NSCLC

EP: 10.Infusion-Related Reactions: Clinical Trials and Guideline-Driven Prophylaxis and Management Strategies for Patients Undergoing NSCLC Treatment

EP: 11.Infusion Hesitancy and the Impact of Route of Administration of NSCLC Treatment Options in Patients’ Quality of Life

EP: 12.Streamlining the Route of Administration of Monoclonal Antibody Therapies for Better Patient Outcomes in the NSCLC Population

EP: 13.Personalized Care: How Do NSCLC Treatment Modifications and Patient-Specific Factors Impact Health Outcomes?

EP: 14.Addressing Critical Gaps in the Management of NSCLC and the Importance of the Next Wave of Treatment Advances

First-Line and Second-Line Treatment Options for EGFR-Positive NSCLC: Recent Clinical Trials

Evolution of Treatment Options

Recent clinical trials have significantly expanded treatment options for patients with EGFR-positive NSCLC, offering choices between:

• Single-agent oral therapy
• Escalation with chemotherapy combinations
• Intravenous and oral combination therapy (amivantamab plus lazertinib)

Key First-Line Clinical Trials

FLAURA2 Trial: Osimertinib Plus Chemotherapy vs Osimertinib Alone

• Efficacy findings:
  • Significantly longer progression-free survival (PFS) with combination therapy
  • Trending toward improved overall survival (data still immature)
  • Improved response rates and duration of response
  • Major PFS improvements for patients with baseline central nervous system metastases
• Safety profile:
  • No new safety signals
  • Toxicities consistent with individual agents' known profiles

MARIPOSA Trial: Amivantamab Plus Lazertinib vs Osimertinib vs Lazertinib Alone

• Efficacy findings:
  • Significantly longer PFS with amivantamab plus lazertinib combination
  • First regimen to show significantly longer overall survival compared with osimertinib
  • Similar response rates to osimertinib but improved duration of response
• Safety profile:
  • Higher rates of treatment discontinuation with combination therapy
  • Increased incidence of infusion-related reactions, venous thromboembolism, and significant dermatologic and ocular toxicities compared with osimertinib alone

Second-Line Treatment Option

MARIPOSA-2 Trial: Post-Osimertinib Progression Setting

• Study arms:
  • Amivantamab plus chemotherapy
  • Amivantamab plus lazertinib plus chemotherapy
  • Chemotherapy alone
• Efficacy findings:
  • Both amivantamab-containing regimens showed significantly longer PFS, higher response rates, and improved intracranial response vs chemotherapy alone
  • Similar intracranial response between the 2 amivantamab arms
• Safety profile:
  • Amivantamab-containing regimens had higher rates of dose interruptions, reductions, and discontinuations
  • Increased infusion-related reactions, dermatologic effects (including stomatitis and paronychia), and worse hematologic toxicities

Treatment for EGFR Exon 20 Insertion Mutations

PAPILLON Trial: First-Line Setting for Exon 20 Mutations

• Study arms:
  • Amivantamab plus chemotherapy
  • Chemotherapy alone
• Efficacy findings:
  • Improved PFS with the combination regimen
  • Overall survival data not mature at time of publication
• Safety profile:
  • Significant EGFR-related toxicities with combination therapy:
  • Dermatologic reactions
  • Ocular adverse effects
  • Infusion-related reactions
  • Higher incidence of hematologic toxicities