Patient Education and IRR Prophylaxis in Practice With Amivantamab/Lazertinib
Panelists discuss how comprehensive patient education about expected adverse effects, combined with prophylactic measures including dexamethasone premedication and dermatologic support, helps patients successfully tolerate amivantamab plus lazertinib therapy while maintaining treatment adherence.
Comprehensive patient education forms the cornerstone of successful amivantamab plus lazertinib implementation, requiring structured approaches to prepare patients for treatment expectations and adverse effect management. Advanced practitioners play a crucial role in conducting pretreatment consultations that cover realistic expectations, anticipated adverse effects, and proactive management strategies. Education protocols typically address the high likelihood of dermatologic toxicities (affecting 86% of patients), with specific instructions for prophylactic doxycycline dosing and topical treatments including betamethasone for inflammatory responses.
Nutritional counseling and supportive care planning are integral components of patient preparation, addressing anticipated appetite changes, gastrointestinal toxicities, and mucositis management. Patients receive detailed instructions for maintaining adequate nutrition through small frequent meals, appropriate protein intake, and hydration strategies, with registered dietitian consultations available as needed. Oral care protocols include specific mouth care regimens and availability of dexamethasone rinses and magic mouthwash for mucositis management.
Infusion reaction prophylaxis has evolved into a standardized protocol that significantly reduces both the incidence and severity of infusion-related reactions. Current best practices include dexamethasone 8 mg twice daily for 2 days prior to infusion combined with montelukast 3 days prior and intravenous steroids on the day of treatment. The infusion center setup includes trained nursing staff familiar with reaction management and immediate access to clinical support. Patient education emphasizes that infusion reactions are expected and manageable, with most reactions resolving with temporary infusion interruption and supportive care, allowing successful treatment continuation. The collaborative approach between physicians, advanced practitioners, pharmacists, and infusion nurses ensures comprehensive patient support throughout the treatment journey.
