First-Line Amivantamab Plus Lazertinib Superior to Osimertinib Among Patients With Locally Advanced or Metastatic EGFR-Mutated Non-Small Cell Lung Cancer

Results from the phase 3 MARIPOSA study found that amivantamab plus lazertinib demonstrated superior efficacy in the first-line setting compared to osimertinib among patients with locally advanced or metastatic epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer (NSCLC). 

According to Byoung Cho, MD, PhD, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea, and coauthors, “amivantamab–lazertinib has shown clinically meaningful and durable antitumor activity in patients with previously untreated or osimertinib-pretreated–mutated advanced [NSCLC].” 

In this international trial, 1074 patients were randomized on a 2-to-2-to-1 basis to receive amivantamab plus lazertinib (n = 429), osimertinib (n = 429), or lazertinib (n = 216). The primary end point was progression-free survival (PFS) among patients in the amivantamab-lazertinib and osimertinib arms. Secondary end points included objective response, confirmed response, and median duration of response (DOR). 

At analysis, median PFS was 23.7 months in the amivantamab-lazertinib arm and 16.6 months in the osimertinib arm (hazard ratio [HR] 0.70; 95% confidence interval [CI], 0.58 to 0.85; P < .001). An objective response was observed in 86% of patients in the amivantamab-lazertinib arm and 85% of patients in the osimertinib arm. A confirmed response was observed in 336 patients in the amivantamab-lazertinib arm and 314 patients in the osimertinib arm. Median DOR was 25.8 months and 16.8 months, respectively. In the amivantamab-lazertinib arm, 10% of patients discontinued treatment due to treatment-related adverse events, compared to 3% of patients in the osimertinib arm. 

As Dr Cho et al concluded, “Amivantamab-lazertinib showed superior efficacy to osimertinib as first-line treatment in EGFR-mutated advanced NSCLC.”

Source: 

Cho BC, Lu S, Felip E, et al. Amivantamab plus lazertinib in previously untreated EGFR-mutated advanced NSCLC. N Engl J Med. Published online: June 26, 2024. doi: 10.1056/NEJMoa2403614