MARIPOSA: Amivantamab and Lazertinib in Frontline EGFR-Mutant NSCLC

This is a synopsis of a Peer Exchange video series featuring Benjamin P. Levy, MD, of Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; Solange Peters, MD, PhD, of University Hospital of Lausanne; Joshua K. Sabari, MD, of NYU Langone’s Perlmutter Cancer Center; Edward B. Garon, MD, MS, of UCLA Jonsson Comprehensive Cancer Center; and Marina Chiara Garassino, MD, of University of Chicago Medicine Comprehensive Cancer Center.

The experts discuss initial results from the phase 3 MARIPOSA-2 trial testing amivantamab plus lazertinib versus osimertinib for untreated EGFR-mutant NSCLC. Dr Sabari explains this three-arm study showed a progression-free survival benefit for the amivantamab-lazertinib combination over osimertinib alone, along with a trend toward improved overall survival. However, he notes additional toxicities like infusion reactions, coagulopathy, and skin rash that require management.

Dr Levy states that while the efficacy results look impressive, determining if the added treatment intensity and toxicity are worthwhile requires considering the patient’s full journey. Dr Garon points out the lack of crossover at progression biases overall survival comparisons to the concurrent chemo-osimertinib arm in the FLAURA2 trial. Dr Peters agrees it is not ideal to directly compare survival outcomes between disparate trials.

The experts concur this exponentially expanding array of first-line options will require careful interpretation and cross-trial comparisons to optimize patient selection. Dr Levy remarks this is an exciting time for the field, but also increasingly complex for practitioners to synthesize all the rapidly emerging data. He states they will need to thoughtfully weigh risks and benefits of more intensive upfront combinations versus sequential treatment strategies for individual patients.

*Video synopsis is AI-generated and reviewed by OncLive editorial staff.