WCLC 2025 - Posters & ePosters-EP.15.09 Clinical Decision Flowchart for Optimizing the Use of EGFR Tyrosine Kinase Inhibitors in Non-Small Cell Lung Cancer: Real-World Data

EP.15.09 Clinical Decision Flowchart for Optimizing the Use of EGFR Tyrosine Kinase Inhibitors in Non-Small Cell Lung Cancer: Real-World Data

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This retrospective cross-sectional study, conducted at a private cancer center in Brazil, evaluated toxicity management in 24 patients with EGFR-mutated non-small cell lung cancer (NSCLC) receiving standard-dose osimertinib (80 mg/day) over an average of 19 months. The cohort was predominantly female (83%), with a mean age of 64 years, and most presented with advanced (stage III-IV) disease.<br /><br />Adverse events (AEs) occurred in 54% of patients, with 37.5% necessitating dose reductions. The most common toxicities were cutaneous (44.4%) and gastrointestinal (33.3%), effectively managed in most cases by reducing osimertinib to 40 mg/day—100% success in skin-related and 66.7% in gastrointestinal AEs. Hepatic toxicities and pneumonitis were less frequent (each 11.1%), with one pneumonitis case leading to treatment discontinuation. Most AEs were grade 1-2, though 80% experienced grade 3 events. Hospitalization was rare (4%), limited to pneumonitis cases.<br /><br />Special attention is needed for elderly patients (>70 years), who exhibited severe gastrointestinal toxicities, and those with cardiac comorbidities, who face elevated cardiovascular risks, emphasizing the need for proactive monitoring.<br /><br />A key innovation from this study is a clinical decision flowchart integrated into a telemonitoring framework, enabling rapid detection and standardized management of AEs through a multidisciplinary team—including an essential nurse navigator role that ensures timely interventions and cohesive symptom management.<br /><br />The findings highlight the critical benefit of proactive telemonitoring combined with multidisciplinary care to reduce treatment interruptions and improve quality of life. Future directions include scaling this model to larger patient populations and incorporating AI-driven predictive analytics to further personalize toxicity management in EGFR-mutant NSCLC patients receiving osimertinib.

Asset Subtitle

Gisele Moreira

Meta Tag

Speaker Gisele Moreira

Topic Multidisciplinary Care: Nursing, Allied Health and Palliative Care

Keywords

EGFR-mutated NSCLC

osimertinib toxicity

cutaneous adverse events

gastrointestinal adverse events

dose reduction

telemonitoring

multidisciplinary care

nurse navigator

elderly patient management

AI predictive analytics