According to second interim analysis results from the MARIPOSA-2 trial, the addition of amivantamab to chemotherapy improved survival and post-progression outcomes among patients with epidermal growth factor receptor (EGFR)-mutated advanced non-small cell lung cancer (NSCLC). 

There were 657 patients enrolled with locally advanced or metastatic EGFR-mutated NSCLC who experienced disease progression on or after osimertinib monotherapy. Patients were randomized on a 2-to-2-to-1 basis to receive amivantamab plus lazertinib and chemotherapy (n = 263), chemotherapy alone (n = 263), or amivantamab plus chemotherapy (n = 131). It has previously been reported that amivantamab plus chemotherapy demonstrated improved progression-free survival (PFS) and showed a favorable trend in overall survival (OS) compared to chemotherapy alone in this population. Reported in this analysis are OS, time to symptomatic progression, time to treatment discontinuation, time to subsequent therapy, and progression-free survival after first subsequent therapy. 

At a median follow-up of 18.1 months, 208 OS events occurred across the amivantamab and chemotherapy alone arms. The median OS was 17.7 months in the amivantamab arm and 15.3 months in the chemotherapy alone arm (hazard ratio [HR], 0.73; 95% confidence interval [CI], 0.54 to 0.99; P = .039) however, the benefit did not reach the prespecified threshold for significance. 

Time to symptomatic progression was 16 months in the amivantamab arm and 11.8 months in the chemotherapy alone arm (HR, 0.73; 95% CI, 0.55 to 0.96; P = .026). Time to treatment discontinuation was 10.4 months in the amivantamab arm and 4.5 months in the chemotherapy alone arm (HR, 0.42; 95% CI, 0.33 to 0.53; P = .0001). Time to subsequent therapy was 12.2 months in the amivantamab arm and 6.6 months in the chemotherapy alone arm (HR, 0.51; 95% CI, 0.39 to 0.65; P = .0001). PFS after first subsequent therapy was 16 months and 11.6 months, respectively (HR, 0.64; 95% CI, 0.48 to 0.85; P = .002).

Study authors concluded, “amivantamab’s multi-targeted mechanism of action and immune-cell directing activity combined with chemotherapy’s antitumor effects is likely contributing to the observed durability.” 

Source: 

Popat S, Reckamp KL, Califano R, et al. Amivantamab plus chemotherapy vs chemotherapy in EGFR-mutated, advanced non-small cell lung cancer after disease progression on osimertinib: 2nd interim overall survival from MARIPOSA-2. Presented at JADPRO Live 2024. November 14-17, 2024. Abstract JL1202ES