Optimizing management of stage IV EGFR mutant non-small cell lung cancer in Asia: An expert opinion
1
Issued Date
2025-01-01
Resource Type
ISSN
00207136
eISSN
10970215
Scopus ID
2-s2.0-105008225784
Journal Title
International Journal of Cancer
Rights Holder(s)
SCOPUS
Bibliographic Citation
International Journal of Cancer (2025)
Suggested Citation
Chang G.C., Kapoor A., Lee C.K., Su C., Chan D., Ladrera G.E.I., Kim H.R., Sumon M.A., Suryavanshi M., Andarini S., Yoshida T., Reungwetwattana T., Nguyen T.K., Voon P.J. Optimizing management of stage IV EGFR mutant non-small cell lung cancer in Asia: An expert opinion. International Journal of Cancer (2025). doi:10.1002/ijc.35512 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/110831
Title
Optimizing management of stage IV EGFR mutant non-small cell lung cancer in Asia: An expert opinion
Author's Affiliation
Universitas Indonesia
National Chung Hsing University
Chung Shan Medical University
National Cancer Center Hospital
Tata Memorial Hospital
Chung Shan Medical University Hospital
St George Hospital
Faculty of Medicine Ramathibodi Hospital, Mahidol University
Amrita Institute of Medical Sciences India
Shanghai Pulmonary Hospital
Yonsei Cancer Hospital
Hospital Umum Sarawak
Kurmitola General Hospital
Oncology Hospital
Icon Cancer Centre
Medical Oncology
National Chung Hsing University
Chung Shan Medical University
National Cancer Center Hospital
Tata Memorial Hospital
Chung Shan Medical University Hospital
St George Hospital
Faculty of Medicine Ramathibodi Hospital, Mahidol University
Amrita Institute of Medical Sciences India
Shanghai Pulmonary Hospital
Yonsei Cancer Hospital
Hospital Umum Sarawak
Kurmitola General Hospital
Oncology Hospital
Icon Cancer Centre
Medical Oncology
Corresponding Author(s)
Other Contributor(s)
Abstract
Lung cancer is Asia's most prevalent cancer, accounting for the highest global patient share. A significant number of non-small cell lung cancer (NSCLC) patients in Asia exhibit mutations in the epidermal growth factor receptor (EGFR). Although clinical outcomes are improving with newer therapies, challenges persist in the effective management of EGFR mutant (EGFRm) NSCLC. Given the substantial disease burden, understanding the current diagnostic and treatment patterns for EGFRm NSCLC from an Asian perspective is essential. This expert opinion presents recommendations from Asian experts on molecular testing and treatment of first-line and second-line EGFRm NSCLC. The recommendations aim to optimize patient outcomes by providing a comprehensive approach to diagnosis and management, considering the high prevalence of EGFR mutations in the Asian population. The experts discussed and recommended approaches for optimal management of EGFRm NSCLC. Next-generation sequencing (NGS) testing is recommended to be included in the reimbursement scheme, and the turnaround time of testing should be shortened, considering the high burden of the disease in Asia. The panel recommended careful selection of patients for osimertinib+chemotherapy or lazertinib+amivantamab based on safety and efficacy profile, patient age, and disease status. While the panel agreed that osimertinib+chemotherapy is acceptable for these patients, dose adjustment and careful patient selection are recommended to optimize safety outcomes. For lazertinib+amivantamab, measures to mitigate adverse events such as the use of pre-medication with steroids, prophylactic anticoagulants, and dose modification are recommended. For patients progressing on one of the combination regimens, experts recommended repeat NGS testing and continued treatment with chemotherapy.