COCOON: Jill Feldman Shares Phase 2 Presentation Insights on Patient-Reported Outcomes

Jill Feldman, cofounder of EGFR Resisters, a patient-driven nonprofit community with the goal of improving outcomes for patients with EGFR-positive lung cancer, joined Lung Cancers Today at the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting to discuss her presentation on phase 2 COCOON trial data as a co-investigator.

Phase 2 of the COCOON trial evaluates the effect of enhanced dermatologic management on the reduction of skin and nail adverse events in patients with EGFR-mutated advanced non–small cell lung cancer (NSCLC) receiving amivantamab plus lazertinib. Feldman presented on patient-reported quality-of-life outcomes from the trial.

“Survival is very important, but patients also want to live, and they want to live well,” Feldman said. “It’s really important to understand the lived experience, especially with side effects.”

Feldman explained that although grade 1 and 2 toxicities may not present as intensely as higher-grade toxicities, the impact of these adverse events on patients can take a toll.

“It may be no big deal at first, kind of annoying. You still don’t need to seek medical attention, but that persistent uncomfortableness absolutely impacts your daily life and impacts what you consider to be tolerable,” she said. “So what the COCOON study really questioned is, can we avoid that?”

In addition, Feldman explained that the study reviewed how a regimen of dermatologic medications−including oral doxycycline or minocycline, clindamycin on the scalp, chlorhexidine on the hands and feet, and noncomedogenic ceramide-based moisturizer on the body and face—affected patients’ daily lives compared with the standard of care.

“Consistently, across the board, [the regimen] showed a significant increase in quality of life when looking at functioning, emotions—quality of life as a whole,” she said. “People in [the intervention] arm had a better quality of life. That’s ultimately what is important— that [the regimen] allows people to live the best life they can in the context of living with this disease and being on treatment.”

Feldman concluded by noting that healthcare professionals should take active steps to inform patients of medications that can help mitigate dermatologic side effects and other toxicities as they initiate treatment for EGFR-positive advanced NSCLC.

“My advice is, whenever you’re talking to patients about first-line treatment, when you’re providing this information on the treatments, this [dermatologic] protocol should absolutely be included because it is a part of care and shouldn’t be sidelined,” she explained. “[The regimen] shouldn’t be an afterthought. It should be presented when you’re talking about the treatment, and for clinicians to start doing that is really important.”