Pragmatic Design and Early Safety Results From COPERNICUS

Wade Iams, MD, MSCI, of Tennessee Oncology, gives Edgardo Santos, MD, FACP, FASCO, of Starling Oncology, an overview of COPERNICUS, a study of subcutaneous amivantamab plus lazertinib in first-line EGFR-mutated advanced non–small cell lung cancer. He starts with MARIPOSA, which showed an overall survival benefit for intravenous amivantamab plus lazertinib over osimertinib but in which about a third of patients stopped amivantamab, usually because of infusion-related reactions, deep vein thrombosis, or dermatologic toxicity. COPERNICUS was designed to deliver the best practices learned since: the subcutaneous formulation, oral lazertinib, the COCOON dermatologic regimen, and prophylactic anticoagulation. Its pragmatic design allows 1 cycle of chemotherapy before enrollment while molecular results are pending and enrolls a broader population by age and demographics. Dr Iams reports that infusion-related reactions, thrombosis, and rash were all lower than in MARIPOSA, with rash falling from roughly 50% to 60% down to roughly 20% to 30%.