Oncology Brothers: Practice-Changing Cancer Discussions Challenging Cases with Metastatic EGFR Mutated Non-Small Cell Lung Cancer with Dr. Eric Singhi
Oct 20, 2025
Dr. Eric Singhi, a thoracic medical oncologist from MD Anderson, shares his expertise on treating EGFR-mutated non-small cell lung cancer. He delves into groundbreaking trials like MARIPOSA and FLAURA2, revealing essential insights into treatment strategies and patient management. The discussion includes real-life patient cases, the significance of repeat tissue profiling, and approaches to manage side effects. Singhi emphasizes the role of multidisciplinary teams and the need to understand resistance patterns for effective treatment planning.
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Combination Improves Brain Control
- The Mariposa trial showed amivantamab+lazertinib doubles intracranial PFS at 36 months versus osimertinib alone.
- This makes combination therapy particularly compelling for patients presenting with de novo brain metastases.
Embed Supportive Care From Day One
- Prescribe supportive measures (Cocoon, VTE prophylaxis, infusion precautions) when starting amivantamab+lazertinib to reduce toxicities.
- Dose interruptions early do not appear to compromise PFS if patients have ~4 months exposure, so prioritize quality of life.
Manage Rash By Adjusting Amivantamab First
- Ensure patients follow a full Cocoon skincare regimen and involve dermatology early for grade ≥2 rashes.
- Hold and reduce amivantamab first while keeping lazertinib at full dose when rash persists after supportive measures.