Roundtable / TTLC 2026 03/14/2026

Ep. 1: OS Benefit and Patient-Centered Delivery Advances in EGFR-Mutant NSCLC

Professional male doctor smiling in a dark suit and blue patterned tie, representing healthcare. Eric Singhi, MD Bright, friendly female healthcare professional in white lab coat smiling, representing medical expertise in oncology, cancer research, and patient care, on the OncUpdates platform. Susan Scott, MD A1: Professional portrait of a smiling woman with curly brown hair, wearing a black blazer, against a dark gray background, representing healthcare or medical professionals. Sarah Goldberg, MD, MPH A healthcare professional in a white lab coat smiling, representing medical expertise in oncology and cancer care. Fawzi Abu Rous, MD A woman in professional attire smiling confidently, representing medical or healthcare professionals in oncology. Julia Rotow, MD

Key Points

  • MARIPOSA demonstrated an approximately 1-year median overall survival (OS) benefit in first-line classical EGFR-mutant metastatic non–small cell lung cancer (NSCLC).
  • Combination therapy is becoming the default approach, with monotherapy reserved for select patients.
  • Subcutaneous amivantamab reduces infusion reactions and visit burden but does not eliminate the need for ongoing dermatologic and toxicity monitoring.

Combination Therapy Becomes the New Standard

The frontline treatment landscape for classical EGFR-mutant metastatic NSCLC has shifted rapidly, as highlighted in a recent Clinical Insights session moderated by Eric Singhi, MD, of The University of Texas MD Anderson Cancer Center. The panel featured Fawzi Abu Rous, MD, of Henry Ford Health; Sarah Goldberg, MD, MPH, of Yale School of Medicine; Julia Rotow, MD, of Dana-Farber Cancer Institute; and Susan C. Scott, MD, of Johns Hopkins Medicine. 

The discussion focused on patients with exon 19 deletions and L858R mutations, emphasizing that clinicians can no longer rely solely on single-agent osimertinib. With the emergence of combination regimens, including amivantamab plus lazertinib in the MARIPOSA trial, the standard of care is evolving.

Dr. Scott underscored the impact of survival data, noting that MARIPOSA demonstrated an approximately 1-year median OS improvement, extending outcomes from about 3 years to about 4 years. Reflecting this shift in practice, Dr. Singhi said he previously asked, “For whom should I escalate therapy?” but now asks, “Who should I de-escalate therapy for?” Dr. Abu Rous echoed this approach: “Once you see overall survival benefit, it’s really hard to ignore.” He noted that combination therapy has become his default unless a clear contraindication exists.

Delivery Improvements Enhance the Patient Experience

The panel also emphasized the importance of optimizing treatment delivery. Dr. Rotow discussed the recent FDA approval of subcutaneous amivantamab, allowing dosing every 4 weeks, as a meaningful advance for patients receiving intensified up-front regimens.