Amivantamab and lazertinib in treatment-naïve EGFR-mutated advanced non–small-cell lung cancer (NSCLC): Long-term follow-up and ctDNA results from CHRYSALIS.

Authors

null

Se-Hoon Lee

Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

Se-Hoon Lee , Byoung Chul Cho , Ji-Youn Han , Eun Kyung Cho , Jong-Seok Lee , Ki Hyeong Lee , Joshua C Curtin , Grace Gao , John Xie , Robert W. Schnepp , Joshua Michael Bauml , Roland E. Knoblauch , Meena Thayu , Dong-Wan Kim

Organizations

Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea, Division of Medical Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea, Republic of (South), National Cancer Center, Goyang-Si, South Korea, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea, Seoul National University Bundang Hospital, Seongnam, South Korea, Chungbuk National University Hospital, Cheongju-Si, South Korea, Janssen R&D, Spring House, PA, Janssen China R&D, Shanghai, China, Janssen R&D, Raritan, NJ, Seoul National University Hospital, Seoul, South Korea

Research Funding

Pharmaceutical/Biotech Company
Janssen R&D, LLC

Background: CHRYSALIS (NCT02609776) evaluated the combination of amivantamab (ami) and lazertinib (laz) in treatment-naïve patients (pts) with epidermal growth factor receptor (EGFR)-mutated NSCLC. As previously reported, all 20 pts achieved a partial response (overall response rate of 100%) but interpretation of long-term outcomes was limited by the length of follow up (Cho Ann Oncol 2020;31:suppl_4, 1258O; Cho J Thorac Oncol 2022;17:S126, P1.16-01). Herein, we present long-term results from this treatment-naïve cohort. Methods: The treatment-naive cohort enrolled pts with EGFR exon 19 deletion (ex19del) or L858R mutated advanced NSCLC. All pts received 1050 mg IV ami (1400 mg if ≥80 kg) and 240 mg oral laz. Response was assessed by the investigator per RECIST v1.1. Circulating tumor DNA (ctDNA) was analyzed from plasma samples prior to initiation of treatment, at Cycle 3 Day 1, and at end of treatment (EOT). Results: Of the 20 pts enrolled in the treatment-naive cohort (median 62.5 years, 55% women, all Asian), 11 had EGFR ex19del and 9 had L858R NSCLC. As of Nov 15, 2022, the median follow-up and duration of treatment were 33.6 and 33.5 months, respectively. Ten (50%) pts were progression-free and remained on treatment, including 7 of 11 (64%) with ex19del and 3 of 9 (33%) with L858R. The median duration of response (DOR), median progression-free survival (PFS), and median overall survival (OS) were not estimable. The estimated landmark PFS rate was 85% at 12 months, 65% at 24 months, and 51% at 36 months. Of note, 2 (10%) pts were treated beyond progression. The longest ongoing pt has a duration of treatment of 37.2 months and DOR of 35.7 months. Treatment-related dose interruptions, reductions, and discontinuations of either ami and laz occurred in 7 (35%) pts, 8 (40%) pts, and 1 (5%) pt, respectively. The safety profile was consistent with prior reports, with predominantly on-target EGFR- or MET-related adverse events. Among the 10 pts who discontinued treatment, 4 submitted samples for ctDNA analysis at both baseline and EOT. There was 1 pt with new PIK3CA mutations, 1 with low-level HER2 amplification, 1 pt with a new CCNE1 and EGFR amplification, and 1 pt with no new mutations detected. Updated data on ctDNA at EOT may be available at the time of congress presentation. Conclusions: At a median duration of treatment of 33.5 months, median DOR, PFS, and OS have not been reached in treatment-naïve pts receiving ami+laz, with 50% remaining progression-free and on treatment. No new safety signals were identified. The ongoing phase 3 MARIPOSA study (NCT04487080) is further investigating ami+laz vs osimertinib vs laz in previously untreated, EGFR-mutated, advanced NSCLC. Clinical trial information: NCT02609776.

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Abstract Details

Meeting

2023 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Lung Cancer—Non-Small Cell Metastatic

Track

Lung Cancer

Sub Track

Metastatic Non–Small Cell Lung Cancer

Clinical Trial Registration Number

NCT02609776

Citation

J Clin Oncol 41, 2023 (suppl 16; abstr 9134)

DOI

10.1200/JCO.2023.41.16_suppl.9134

Abstract #

9134

Poster Bd #

122

Abstract Disclosures