Amivantamab Plus Lazertinib Combo Shows Good Results in EGFR+ NSCLC

Alexander Spira, MD, PhD, a medical oncologist and director of the Virginia Cancer Specialists Research Institute and the Phase 1 Trial Program, discusses the phase 1 CHRYSALIS trial of amivantamab (JNJ-61186372) plus lazertinib (YH25448) in 2 EGFR-mutant non–small cell lung cancer patient populations, which include patients with relapsed/refractory and those who are treatment-naive.

In the relapsed/refractory population, there was about a 36% or 37% response rate, with significantly more patients benefiting. This is good because it's designed as a non-chemotherapy option since chemotherapy would be the normal approach for these patients, according to Spira. Since the proof of concept worked, there is potential for a non-chemotherapy option in this setting.

Spira explains the investigators combined these drugs because amivantamab is a monoclonal antibody, which do not tend to penetrate the brain, and by continuing to administer with the small molecule lazertinib, the idea is that you could both overcome resistance, as well as prevent brain recurrence, in addition to having a 2-fold attack on tyrosine kinase inhibitor therapy.

The second patient population of those who were treatment naïve had a 100% response rate. Spira says this is almost unheard of. With this combination, standard EGFR toxicities were increased more than we would typically see. Most commonly, these included nail changes or a rash. Because of amivantamab is a fusional drug and a monoclonal antibody, there were some infusion-related reactions. With good monitoring, most patients were able to get the first dose split over 2 days.