In this episode of the Oncology Brothers podcast, we dived into the evolving landscape of anti-EGFR drugs used in non-small cell lung cancer (NSCLC) with EGFR mutations. Joined by Dr. Gilberto Lopes, a thoracic medical oncologist from the Sylvester Cancer Center, we explored the latest advancements and clinical pearls in managing these therapies.
We started by discussing Afatinib, which is now often reserved for uncommon EGFR mutations. Dr. Lopes highlights the significant side effects associated with Afatinib, particularly diarrhea, skin toxicity, and mucositis. He emphasized the importance of proactive management strategies, including dose reductions and the use of oral antibiotics to mitigate skin-related issues.
As we transitioned to Osimertinib, we note its improved tolerability compared to earlier agents. Dr. Lopes shared insights on managing skin toxicity and the potential for cardiotoxicity, reminding us to monitor patients closely, especially those with pre-existing cardiac conditions.
The conversation then shifted to the promising combination of Amivantamab and Lazertinib. Dr. Lopes discussed the infusion-related reactions that can occur with Amivantamab and the strategies to reduce these risks, including the use of dexamethasone as prophylaxis. He also outlined the proactive measures from the COCOON study to manage skin toxicity effectively.
Throughout the episode, we stressed the importance of early intervention and proactive management of side effects to maximize patient comfort and treatment efficacy.
As we wrapped up, we recapped the key takeaways: managing diarrhea with Afatinib, addressing low-grade side effects with Osimertinib, and the unique side effects associated with the Amivantamab and Lazertinib combination.