Cutaneous Toxicities With Amivantamab for Non-Small Cell Lung Cancer: A Practical Guide and Best Practices
Shahnaz Singh-Kandah1, Kaiwen Wang2, Karen Xia3
1NewYork-Presbyterian/Columbia University Irving Medical Center.
Background:
Amivantamab is an epidermal growth factor receptor (EGFR) and MET bispecific antibody approved for certain patients with advanced non-small cell lung cancer with EGFR variant. Cutaneous toxicities are known on-target effects of EGFR inhibition.
Objectives:
This article describes the occurrence and management of cutaneous toxicities in patients whose disease progressed on platinum chemotherapy treated with amivantamab.
Methods:
Post hoc analysis evaluated incidence, severity, and time to first onset of rash and paronychia. Five nurses and advanced practice providers were interviewed.
Findings:
Of 380 patients, 296 (78%) experienced treatment-related rash and/or paronychia. Paronychia (43%), rash (36%), and dermatitis acneiform (35%) were most frequent, with scalp rash reported by 17%. Treatment modifications because of rash and paronychia were infrequent. Nurses and advanced practice providers collaborate with physicians to manage cutaneous toxicities by administering comedications, modifying amivantamab dose, and educating patients.
Insights
Amivantamab treatment for advanced non-small cell lung cancer commonly causes skin issues like rash and paronychia. Management strategies involving dose adjustments and patient education help mitigate these toxicities.
Area of Science:
- Oncology
- Dermatology
- Pharmacology
Background:
- Amivantamab is an EGFR and MET bispecific antibody for advanced non-small cell lung cancer (NSCLC).
- Cutaneous toxicities are known side effects of EGFR inhibition therapy.
Purpose of the Study:
- To describe the occurrence and management of skin toxicities in NSCLC patients treated with amivantamab after platinum chemotherapy progression.
Main Methods:
- Post hoc analysis of patient data to assess rash and paronychia incidence, severity, and onset.
- Qualitative interviews with healthcare providers managing these toxicities.
Main Results:
- 78% of patients experienced treatment-related rash and/or paronychia.
- Most frequent toxicities included paronychia (43%), rash (36%), and acneiform dermatitis (35%).
- Treatment modifications were infrequent; collaborative management by nurses and physicians was key.
Conclusions:
- Cutaneous toxicities are common but manageable with amivantamab treatment in advanced NSCLC.
- Multidisciplinary management involving comedications, dose adjustments, and patient education is effective.
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