Overview of Frontline EGFR+ NSCLC, Including MARIPOSA Survival Benefit

This presentation focuses on recent advancements in the frontline treatment of EGFR-mutated NSCLC. Although osimertinib has long been the standard therapy, 2 new regimens are reshaping the treatment landscape. One is the FLORA2 regimen, which combines osimertinib with platinum-based chemotherapy and pemetrexed. The other, known as the MARIPOSA regimen, pairs a third-generation tyrosine kinase inhibitor with a bispecific antibody targeting EGFR and MET. The MARIPOSA regimen has shown a potential overall survival benefit of up to 1 year, which is considered a significant improvement.

These developments have led to more options for patients, particularly those with more aggressive or high-burden disease. Although some patients may continue to do well on oral osimertinib alone, others—especially those with brain or liver metastases, high symptom burden, or mutations like RB and TP53—may benefit from more intensive approaches. Importantly, these new regimens involve either chemotherapy or injectable therapies, which may affect patient preferences and logistical considerations. Physicians must weigh these factors, especially when dealing with younger or more motivated patients who seek aggressive treatment strategies.

Treatment decisions are moving toward a more personalized and collaborative model. Shared decision-making between patients and clinicians is essential, considering disease characteristics, adverse effect profiles, and patient lifestyles. Although the current standard, osimertinib, remains a viable and familiar option, the treatment paradigm is evolving. As clinical trial results continue to emerge, especially around overall survival, the oncology community must adapt, tailoring therapy based on medical and patient-centered factors. This period marks a promising shift in the management of EGFR-mutated NSCLC, with more tools now available to extend survival and improve outcomes.