Predictive biomarkers for treatment with amivantamab plus lazertinib among EGFR-mutated NSCLC in the post-osimertinib setting: Analysis of tissue IHC and ctDNA NGS.

Authors

null

Benjamin Besse

Gustave Roussy, Villejuif, France

Benjamin Besse , Christina S Baik , Melina Elpi Marmarelis , Joshua K. Sabari , Koichi Goto , Catherine A. Shu , Jong-Seok Lee , Sai-Hong Ignatius Ou , Byoung Chul Cho , Saiama Naheed Waqar , Aurélie Swalduz , Pascale Tomasini , Joshua Michael Bauml , Joshua C Curtin , Songbai Wang , Tim Jatkoe , Michael Gormley , Leonardo Trani , Roland Elmar Knoblauch , Enriqueta Felip

Organizations

Gustave Roussy, Villejuif, France, University of Washington School of Medicine, Seattle, WA, University of Pennsylvania, Philadelphia, PA, New York University, New York, NY, National Cancer Center Hospital East, Kashiwa, Japan, Columbia University Medical Center, New York, NY, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea, University of California-Irvine, Chao Family Comprehensive Cancer Center, Orange, CA, Yonsei University College of Medicine, Seoul, Korea, Republic of (South), Washington University School of Medicine, St. Louis, MO, Centre Leon BERARD, Service d'Oncologie Médicale, Lyon, France, APHM, Service d'Oncologie Multidisciplinaire & Innovations Thérapeutiques, Hôpital Nord, Marseille, France, Janssen Research and Development, Spring House, PA, Janssen R&D, Spring House, PA, Johnson & Johnson, Spring House, PA, Janssen Pharmaceuticals, Raritan, NJ, Janssen Research and Development LLC, Spring House, PA, Janssen Pharmaceuticals Inc, Spring House, PA, Vall d’Hebron University Hospital, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain

Research Funding

Pharmaceutical/Biotech Company
Janssen

Background: Amivantamab (ami) is a bispecific antibody targeting EGFR and MET with immune cell-directing activity, and lazertinib (laz) is a brain-penetrant, third-generation EGFR tyrosine kinase inhibitor. In a previous report, the overall response rate (ORR) of ami+laz in the post-osimertinib (osi) setting was 36%, with median duration of response of 9.6 months (Bauml JCO 2021; 39:15_suppl, 9006). Exploratory analyses suggested certain immunohistochemistry (IHC) and ctDNA-based next-generation sequencing (NGS) biomarkers may enrich for response. A prospective study was conducted to further evaluate these potential biomarkers. Methods: CHRYSALIS-2 (NCT04077463), an ongoing phase 1/1b study, examines the efficacy (ORR per RECIST v1.1) of ami+laz in patients (pts) with EGFR-mutated NSCLC. Cohort D enrolled osi-relapsed, chemotherapy-naïve pts with EGFR exon 19 deletion or L858R mutated advanced NSCLC who had tumor tissue for IHC staining and plasma for ctDNA NGS collected after their most recent therapy. Training and validation subsets identified biomarker criteria and predictive validity, respectively. A Bayesian posterior probability (biomarker positive group ORR is ≥35% and negative group ORR is ≤20%) was predefined to be ≥85% for acceptance. Results: There were 101 response-evaluable pts enrolled in Cohort D. A total of 87 pts had detectable baseline ctDNA and 77 pts had evaluable MET IHC. The training set (n = 50) identified IHC-based MET expression of 3+ staining on ≥25% of tumor cells (MET+) as a potential predictive biomarker, and the validation set (n = 27) confirmed these results. Of those with MET IHC data, 28/77 (36%) were MET+. The overall ORR for MET+ was 61% (95% CI, 41–78) and 12% (95% CI, 5–25) for MET-, with median PFS for MET+ not reached (95% CI, 4.3–NE) vs 4.1 months (95% CI, 2.8–5.7) for MET-. NGS evaluation of ctDNA did not identify predictive biomarkers meeting predetermined criteria. Of note, only 1 pt was identified by ctDNA as having MET amplification (the pt was also MET+ by IHC). Further details will be provided at the time of presentation. Conclusions: MET+ by IHC may be a predictive biomarker for response to ami+laz in the post-osi, chemotherapy-naïve setting. In contrast, molecular profiling with ctDNA failed to identify a subgroup of pts more likely to benefit. Ami+laz represents a potential chemotherapy-free option for pts with EGFR-mutated advanced NSCLC who have progressed on osi and are also MET+ by IHC. Clinical trial information: NCT04077463.

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Abstract Details

Meeting

2023 ASCO Annual Meeting

Session Type

Clinical Science Symposium

Session Title

New Partners for EGFR-Mutant Lung Cancer

Track

Lung Cancer

Sub Track

Metastatic Non–Small Cell Lung Cancer

Clinical Trial Registration Number

NCT04077463

Citation

J Clin Oncol 41, 2023 (suppl 16; abstr 9013)

DOI

10.1200/JCO.2023.41.16_suppl.9013

Abstract #

9013

Abstract Disclosures