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Real-World Efficacy and Safety of Amivantamab for EGFR-Mutant NSCLC.

Authors :
Wang K
Du R
Myall NJ
Lewis WE
Uy N
Hong L
Skoulidis F
Byers LA
Tsao A
Cascone T
Pozadzides J
Tu J
Negrao MV
Gibbons DL
Park K
Rinsurongkawong W
Lee JJ
Gandara D
Behl D
Shu CA
Riess JW
Baik C
Wakelee HA
Vaporciyan AA
Heymach JV
Zhang J
Le X
Source :
Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer [J Thorac Oncol] 2024 Mar; Vol. 19 (3), pp. 500-506. Date of Electronic Publication: 2023 Nov 25.
Publication Year :
2024

Abstract

Introduction: Amivantamab-vmjw (amivantamab) is a bispecific EGFR/MET antibody approved for patients with advanced NSCLC with EGFR exon 20 insertion mutations, after prior therapy. Nevertheless, the benefits and safety of amivantamab in other EGFR-mutant lung cancer, with or without osimertinib, and with concurrent radiation therapy, are less known.<br />Methods: We queried the MD Anderson Lung Cancer GEMINI, Fred Hutchinson Cancer Research Center, University of California Davis Comprehensive Cancer Center, and Stanford Cancer Center's database for patients with EGFR-mutant NSCLC treated with amivantamab, not on a clinical trial. The data analyzed included initial response, duration of treatment, and concomitant radiation safety in overall population and prespecified subgroups.<br />Results: A total of 61 patients received amivantamab. Median age was 65 (31-81) years old; 72.1% were female; and 77% were patients with never smoking history. Median number of prior lines of therapies was four. On the basis of tumor's EGFR mutation, 39 patients were in the classical mutation cohort, 15 patients in the exon 20 cohort, and seven patients in the atypical cohort. There were 37 patients (58.7%) who received amivantamab concomitantly with osimertinib and 25 patients (39.1%) who received concomitant radiation. Furthermore, 54 patients were assessable for response in the overall population; 19 patients (45.2%) had clinical response and disease control rate (DCR) was 64.3%. In the classical mutation cohort of the 33 assessable patients, 12 (36.4%) had clinical response and DCR was 48.5%. In the atypical mutation cohort, six of the seven patients (85.7%) had clinical response and DCR was 100%. Of the 13 assessable patients in the exon 20 cohort, five patients (35.7%) had clinical response and DCR was 64.3%. Adverse events reported with amivantamab use were similar as previously described in product labeling. No additional toxicities were noted when amivantamab was given with radiation with or without osimertinib.<br />Conclusions: Our real-world multicenter analysis revealed that amivantamab is a potentially effective treatment option for patients with EGFR mutations outside of exon 20 insertion mutations. The combination of osimertinib with amivantamab is safe and feasible. Radiation therapy also seems safe when administered sequentially or concurrently with amivantamab.<br /> (Copyright © 2023 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.)

Details

Language :
English
ISSN :
1556-1380
Volume :
19
Issue :
3
Database :
MEDLINE
Journal :
Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
Publication Type :
Academic Journal
Accession number :
38012986
Full Text :
https://doi.org/10.1016/j.jtho.2023.11.020