Amivantamab plus lazertinib in osimertinib-relapsed EGFR-mutant advanced non-small cell lung cancer: a phase 1 trial

Byoung Chul Cho, Dong Wan Kim, Alexander I. Spira, Jorge E. Gomez, Eric B. Haura, Sang We Kim, Rachel E. Sanborn, Eun Kyung Cho, Ki Hyeong Lee, Anna Minchom, Jong Seok Lee, Ji Youn Han, Misako Nagasaka, Joshua K. Sabari, Sai Hong Ignatius Ou, Patricia Lorenzini, Joshua M. Bauml, Joshua C. Curtin, Amy Roshak, Grace GaoJohn Xie, Meena Thayu, Roland E. Knoblauch, Keunchil Park

Research output: Contribution to journalArticlepeer-review

25 Scopus citations

Abstract

Patients with epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer (NSCLC) often develop resistance to current standard third-generation EGFR tyrosine kinase inhibitors (TKIs); no targeted treatments are approved in the osimertinib-relapsed setting. In this open-label, dose-escalation and dose-expansion phase 1 trial, the potential for improved anti-tumor activity by combining amivantamab, an EGFR-MET bispecific antibody, with lazertinib, a third-generation EGFR TKI, was evaluated in patients with EGFR-mutant NSCLC whose disease progressed on third-generation TKI monotherapy but were chemotherapy naive (CHRYSALIS cohort E). In the dose-escalation phase, the recommended phase 2 combination dose was established; in the dose-expansion phase, the primary endpoints were safety and overall response rate, and key secondary endpoints included progression-free survival and overall survival. The safety profile of amivantamab and lazertinib was generally consistent with previous experience of each agent alone, with 4% experiencing grade ≥3 events; no new safety signals were identified. In an exploratory cohort of 45 patients who were enrolled without biomarker selection, the primary endpoint of investigator-assessed overall response rate was 36% (95% confidence interval, 22–51). The median duration of response was 9.6 months, and the median progression-free survival was 4.9 months. Next-generation sequencing and immunohistochemistry analyses identified high EGFR and/or MET expression as potential predictive biomarkers of response, which will need to be validated with prospective assessment. ClinicalTrials.gov identifier: NCT02609776 .

Original languageEnglish
Pages (from-to)2577-2585
Number of pages9
JournalNature Medicine
Volume29
Issue number10
DOIs
StatePublished - Oct 2023

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