Amivantamab Associated With Improved Outcomes vs Real-World Therapies in EGFR-Mutated NSCLC

Among patients with epidermal growth factor receptor (EGFR) exon 20 insertion-mutated advanced non–small-cell lung cancer (NSCLC) who progressed after platinum-based chemotherapy, treatment with amivantamab was associated with improved outcomes vs external controls, according to a study published in Lung Cancer.

“In the single-arm CHRYSALIS study, amivantamab showed durable responses and manageable safety in patients with advanced [NSCLC] harboring [EGFR] exon 20 insertion mutations who progressed on prior platinum-based chemotherapy,” wrote Anna Minchom, MD, Royal Marsden/Institute of Cancer Research, Sutton, United Kingdom, and colleagues.

For this study, researchers selected external controls from the ConcertAI, COTA, and Flatiron databases. Patients were included if they had EGFR exon 20 insertion mutated advanced NSCLC, receipt of prior platinum-based chemotherapy, and a performance status score ≤1. Propensity score weighting adjusted for differences in baseline characteristics between patients treated with amivantamab and external controls.

A total of 206 patients were included in the analysis who received amivantamab (n = 81) or external controls (n = 125). The most common therapies received by patients in the external controls cohort were non–platinum-based chemotherapy (25.1%), immunotherapies (24.2%), EGFR tyrosine kinase inhibitors (16.3%), and platinum-based chemotherapy (16.3%).

The overall response rate (ORR) was 40% in the amivantamab arm vs 16% in the external controls arm. Median progression-free survival (PFS) was 8.3 months vs 2.9 months, respectively (hazard ratio [HR], 0.47; 95% confidence interval [CI], 0.34 to 0.65). Median time to next therapy (TTNT) was 14.8 months in the amivantamab group vs 4.8 months in the external controls group (HR, 0.40; 95% CI, 0.28 to 0.57). Median overall survival (OS) was 22.8 months vs 12.8 months, respectively (HR, 0.49; 95% CI, 0.31 to 0.77).

“In conclusion, patients with advanced NSCLC harboring EGFR exon 20 insertion mutations whose disease progressed on or after platinum-based chemotherapy have poor prognoses and are in need of more effective therapies. Amivantamab improved ORR, OS, PFS, and TTNT compared to real-world therapies,” concluded Dr Minchom and colleagues.

Source:

Minchom A, Viteri S, Bazhenova L, et al. Amivantamab compared with real-world therapies in patients with advanced non-small cell lung cancer harboring EGFR exon 20 insertion mutations who progressed after platinum-based chemotherapy. Lung Cancer. 2022 Jun;168:74-82. doi:10.1016/j.lungcan.2022.03.005.