Shifting From Reactive to Proactive Adverse Event Management

Prophylaxis works only when patients treat it as part of a daily routine, says Amanda Edmond, PA-C, of Banner MD Anderson Cancer Center at Banner Gateway Medical Center, discussing amivantamab plus lazertinib in EGFR-mutated non-small cell lung cancer. She contrasts MARIPOSA, where no prophylactic strategies were used and clinicians could respond only after adverse events appeared, with COPERNICUS, which applies the COCOON protocol to help prevent venous thromboembolism, including pulmonary embolism and deep vein thrombosis, alongside skin care prophylaxis for paronychia and rash. Edmond starts the conversation as soon as the treatment decision is made, using an education visit and handouts to frame prophylaxis as routine, comparable with taking a vitamin or brushing teeth. Her approach includes daily chlorhexidine nail soaks on fingernails and toenails, a ceramide-containing moisturizer over the whole body, daily sunscreen or sun-protective clothing, twice-daily doxycycline or minocycline, and an anticoagulant, all started before cycle 1, day 1.