Counseling and Proactive AE Management vs. Cetuximab

Paul L. Swiecicki, MD, of the University of Michigan Rogel Cancer Center, discusses how community oncologists should counsel and manage adverse events (AEs) with subcutaneous amivantamab in head and neck squamous cell carcinoma. He notes that cohort 1 of OrigAMI-4 showed a higher incidence of toxicity with single-agent amivantamab compared with single-agent cetuximab, including hypoalbuminemia, which he attributes to MET-pathway targeting, along with acneiform dermatitis and rash. Dr Swiecicki recommends a proactive, team-based management approach that includes education of nursing staff and pharmacists as well as patient counseling, drawing on lessons learned from thoracic oncology colleagues who have used amivantamab in non-small cell lung cancer (NSCLC). He also flags that as EGFR bispecific antibodies move into combination regimens with other agents, clinicians will need to anticipate potential synergistic toxicities and plan prophylactic management strategies that address both agents' side-effect profiles simultaneously.