Prevention and Management of Dermatologic Adverse Events in Patients Treated with Amivantamab Plus Lazertinib

Amivantamab plus lazertinib (amivantamab+lazertinib) is a novel combination therapy used to treat epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer (NSCLC). Although this regimen has demonstrated clinical efficacy in locally advanced or metastatic NSCLC, it is associated with a range of dermatologic adverse events that may develop rapidly and require prompt intervention. Early management of these side effects is critical for maintaining oncologic treatment, optimizing clinical outcomes, and improving patients' quality of life. Cases: We present four patients with EGFR-mutated NSCLC who experienced dermatologic adverse events during amivantamab+lazertinib therapy. Two developed severe facial papulopustular eruptions, and two presented with necrotic folliculitis with sanguineous scalp erosions. Additional dermatologic manifestations included paronychia, pruritus, xerosis, mucositis, and trichomegaly. Notably, one patient experienced milder dermatologic side effects due to early initiation of a dermatologic prophylactic regimen. Conclusions: Dermatologic adverse events during amivantamab+lazertinib therapy are frequent and may be more severe than those typically observed with EGFR inhibitors. Early prophylactic measures and timely intervention are essential for managing these adverse events, supporting treatment adherence, and maximizing the therapeutic efficacy of this combined oncologic regimen.