28 juli 2022: Bron: 2022 Feb;18(6):639-647.

Amivantamab (Rybrevant) en Lazertinib (LECLAZA®) samen gegeven bij gevorderde niet-kleincellige longkanker met EGFR-mutaties geeft goede resultaten, vooral bij die patiënten die al eerder osimertinib plus chemotherapie hadden gehad maar desondanks progressie van hun ziekte kregen of een recidief. 

Wat de onderzoekers ontdekten in deze studie: A Study of Amivantamab and Lazertinib Combination Therapy Versus Osimertinib in Locally Advanced or Metastatic Non-Small Cell Lung Cancer (MARIPOSA)
was dat het responspercentage, dus waar de behandeling bij aanslaat met minimaal een gedeeltelijke remissie (PR), in deze eerder behandelde groep van patiënten alsnog ongeveer 36% was en dat de mediane duur van de remissie nog niet was bereikt. Maar verschillende patiënten hadden lang durende duurzame reacties, en de bijwerkingen waren redelijk volgens de onderzoekers.

Osimertinib en Lazertinib zijn zogeheten EGFR-tyrosine kinase remmers (TKI's). Amivantamab (Rybrevant is een bispecifiek antilichaam tegen EGFR-mutaties en MET. Dit antilichaam kan de tumorgroei remmen die wordt aangestuurd door EGFR en mesenchymale-epitheliale transitie (MET) - receptoren. 

Omdat het tussenresultaten zijn die werden gepresenteerd op ASCO 2022 is er nog geen definitief abstract of volledig studierapport beschikbaar want de MARIPOSSA studie loopt nog, maar hier een update van de studieresultaten d.d. 15 juli 2022. Klik op de titel voor het gepubliceerde abstract:

Clinical Trial
 
2022 Feb;18(6):639-647.
 doi: 10.2217/fon-2021-0923. Epub 2021 Dec 16.

MARIPOSA: phase 3 study of first-line amivantamab + lazertinib versus osimertinib in EGFR-mutant non-small-cell lung cancer

Affiliations 

Abstract

Third-generation EGFR tyrosine kinase inhibitors (TKIs), such as osimertinib, have demonstrated efficacy in patients with EGFR-mutant non-small-cell lung cancer; however, almost all patients will eventually relapse. Amivantamab is an EGFR-MET bispecific antibody with immune cell-directing activity that targets activating and resistance EGFR mutations and MET mutations and amplifications. In the ongoing CHRYSALIS study (NCT02609776), amivantamab in combination with lazertinib, a potent, brain-penetrant third-generation EGFR TKI, demonstrated antitumor activity in the treatment-naive and osimertinib-relapsed setting. Here the authors present the methodology for the MARIPOSA study (NCT04487080), a phase 3, multicenter, randomized study designed to compare the efficacy and safety of amivantamab and lazertinib combination therapy versus single-agent osimertinib as first-line treatment for EGFR-mutant non-small-cell lung cancer.

Keywords: EGFR mutations; amivantamab; lazertinib; non-small-cell lung cancer; tyrosine kinase inhibitors.

Plain language summary

Plain language summary Osimertinib is the standard-of-care treatment for patients with non-small-cell lung cancer caused by mutations in the EGFR. However, patients will eventually see their disease return because their tumors will develop new mutations that are resistant to osimertinib treatment. Amivantamab is a new antibody treatment that blocks the EGFR and another receptor called the MET receptor, to stop the growth of lung tumor cells. In an ongoing clinical trial, called the CHRYSALIS study, when amivantamab was given with lazertinib (another drug that blocks the EGFR), lung tumors shrank in patients whose lung cancer had not been previously treated. A new clinical trial called the MARIPOSA study (NCT04487080) aims to compare the antitumor activity and safety of the amivantamab + lazertinib combination versus osimertinib alone in patients with EGFR-mutant non-small-cell lung cancer who have not received treatment for their lung cancer. Trial registration number: NCT04487080 (ClinicalTrials.gov).

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