Dr Reckamp on Amivantamab in EGFR Exon 20–Mutated NSCLC

Karen L. Reckamp, MD, MS, professor of medicine, director, Division of Medical Oncology and Lung Institute, Cedars-Sinai Medical Center, associate director, Clinical Research, Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute, discusses the role of amivantamab-vmjw (Rybrevant) in the treatment of patients with non–small cell lung cancer (NSCLC) harboring EGFR exon 20 insertion mutations.

On March 1, 2024, the FDA approved amivantamab plus carboplatin and pemetrexed for the frontline treatment of patients with locally advanced or metastatic NSCLC harboring EGFR exon 20 insertion mutations, as detected by an FDA-approved test. The agent also received accelerated approval in May 2021 as monotherapy for the treatment of adult patients with locally advanced or metastatic NSCLC with EGFR exon 20 insertion mutations, as detected by an FDA-approved test, whose disease has progressed on or after platinum-based chemotherapy.

In the phase 3 PAPILLON study (NCT04538664), which supported the frontline approval of amivantamab plus chemotherapy, those treated with the combination (n = 153) experienced a median progression-free survival (PFS) of 11.4 months (95% CI, 9.8-13.7) vs 6.7 months (95% CI, 5.6-7.3) for those given chemotherapy alone (n = 155; HR, 0.40; 95% CI, 0.30-0.53; P < .0001).

Reckamp explains that amivantamab has become the primary targeted therapy considered for the treatment of patients with advanced NSCLC harboring EGFR exon 20 insertion mutations. The EGFR- and MET-targeted antibody has demonstrated significant efficacy in previously treated patients, as well as in the frontline setting when combined with chemotherapy, she says. This dual-targeted approach has resulted in notable improvements in response rates and progression-free survival (PFS), she adds.

Reckamp emphasizes that the integration of amivantamab into treatment protocols represents a major shift in the treatment of patients with EGFR exon 20–mutated NSCLC. With improved outcomes over chemotherapy alone, amivantamab offers a valuable option for patients, potentially leading to better overall survival and disease control, she concludes.