Amivantamab-vmjw

(Rybrevant®)

Rybrevant®

Drug updated on 12/11/2024

Dosage FormInjection (intravenous; 350 mg/7 mL [50 mg/mL])
Drug ClassBispecific EGF receptor-directed and MET receptor-directed antibodies
Ongoing and
Completed Studies
ClinicalTrials.gov

Indication

  • Indicated in combination with lazertinib for the first-line treatment of adult patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) exon 19 deletions or exon 21 L858R substitution mutations, as detected by an FDA-approved test
  • Indicated in combination with carboplatin and pemetrexed for the treatment of adult patients with locally advanced or metastatic NSCLC with EGFR exon 19 deletions or exon 21 L858R substitution mutations, whose disease has progressed on or after treatment with an EGFR tyrosine kinase inhibitor
  • Indicated in in combination with carboplatin and pemetrexed for the first-line treatment of adult patients with locally advanced or metastatic NSCLC with EGFR exon 20 insertion mutations, as detected by an FDA-approved test
  • Indicated as a single agent for the treatment of adult patients with locally advanced or metastatic NSCLC with EGFR exon 20 insertion mutations, as detected by an FDA-approved test, whose disease has progressed on or after platinum-based chemotherapy

Latest News

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Summary
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  • This summary is based on the review of two randomized controlled trial(s). [1-2]
  • Amivantamab-containing regimens significantly improved progression-free survival (PFS) compared to chemotherapy alone. One study reported hazard ratios (HR) for disease progression or death of 0.48 and 0.44 (P < 0.001), with median PFS of 6.3 and 8.3 months, respectively, compared to 4.2 months for chemotherapy alone. Another study reported a median PFS of 11.4 months for amivantamab-chemotherapy versus 6.7 months for chemotherapy alone (HR: 0.40, 95% confidence interval (CI) (33% maturity): 0.30-0.53, P < 0.001).
  • Overall Response Rate (ORR) was significantly higher in amivantamab-containing regimens. One study reported ORRs of 64% and 63% for amivantamab-chemotherapy combinations compared to 36% for chemotherapy alone (P < 0.001). Another found a response rate of 73% for amivantamab-chemotherapy compared to 47% for chemotherapy alone (rate ratio: 1.50, 95% CI: 1.32-1.68, P < 0.001).
  • Amivantamab-chemotherapy and amivantamab-lazertinib-chemotherapy also prolonged intracranial PFS. One study reported median intracranial PFS of 12.5 and 12.8 months, respectively, compared to 8.3 months for chemotherapy alone. The HR for intracranial disease progression or death was 0.55 and 0.58, respectively.
  • Hematologic and the epidermal growth factor receptor (EGFR) (Funded by Janssen Research and Development; PAPILLON ClinicalTrials.gov number, NCT04538664.)-related toxicities were predominant in amivantamab-containing regimens. In one study, the amivantamab-lazertinib-chemotherapy group had higher hematologic adverse events (AEs) than the amivantamab-chemotherapy group, but both groups experienced significant toxicities. Another study reported that 7% of patients discontinued amivantamab due to adverse reactions, with reversible hematologic and EGFR-related toxicities being the most common.
  • Amivantamab-containing regimens had more toxicities compared to chemotherapy alone. Specifically, one study highlighted that significant hematologic toxicities in the amivantamab-lazertinib-chemotherapy group necessitated a regimen change.
  • One study included patients with EGFR-mutated advanced non-small cell lung cancer (NSCLC) (exon 19 deletions or L858R). Consistent PFS outcomes were observed in patients with a history of brain metastases and prior brain radiation. Another study focused on patients with advanced NSCLC harboring EGFR exon 20 insertions, who had not received prior systemic therapy. No specific subgroup findings were highlighted.

Product Monograph / Prescribing Information

Document TitleYearSource
Rybrevant (amivantamab-vmjw) Prescribing Information.2024Janssen Biotech, Inc., Horsham, PA

Randomized Controlled Trials


Sex Distribution:

F:58%
M:42%
308Subjects

Year:

2023

Source:The New England Journal of Medicine