Spira on the MARIPOSA Trial of Amivantamab/Lazertinib in EGFRm NSCLC

The phase 3 MARIPOSA trial (NCT04487080) investigating the regimen of amivantamab-vmjw (Rybrevant) and lazertinib vs standard-of-care osimertinib (Tagrisso) for the treatment of EGFR-mutated non-small cell lung cancer (NSCLC) showed promising results for the superiority of amivantamab/lazertinib over osimertinib.

The combination delivered a longer progression-free survival (PFS) and duration of response (DOR) with a positive overall survival trend. However, questions about the regimen remain. However, a further area of investigation foucuses on the efficacy of the combination regimen if the dose needs to be interrupted.

According to Alex Spira, MD, PhD, FACP, the analysis identified that patients who received dose interruptions within the first 4 months of treatment had a median PFS similar to patients who did not receive dose interruptions.

Here, Spira, thoracic oncologist at Virginia Cancer Specialists, discusses this subset analysis of the MARIPOSA trial.

Transcription:

0:05 | What is found in MARIPOSA that dose interruptions do not affect outcomes that much. If we look at a couple of things, patients who got those interruptions who didn't get those interruptions, we did not see much of a difference in response rates and duration of response; they were pretty much identical. The [adverse] effects were as expected, and the progression-free survival [curves are] basically identical. At 24 months, it was 52% in both arms, with no differences whatsoever.

0:31 | The good news is, if you decide to interrupt [patients] for whatever reason, patients did just as well. The concern is if they have to stop the drug, [they will] lose some of the benefits. But clearly, we are still getting enough dose intensity and patients can still do well, even with occasional dose interruptions. On the study, what we found was physicians could do dose interruptions as they needed. If a patient's having too many [adverse] effects, if they traveled, if a patient required a dose interruption… we should feel very comfortable that it's okay to hold the dose as needed for adverse events, and patients should do just as well.