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Efficacy and Safety of Amivantamab in Advanced or Metastatic EGFR-Mutant Non-Small Cell Lung Cancer: A Systematic
Ionas Papassotiriou1, Antonios Kapogiannatos1, Christos Makatsoris1
1Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece.
Abstract:
Objectives: This systematic review aimed to examine the efficacy and safety profile of amivantamab in patients with advanced or metastatic non-small cell lung cancer (NSCLC) and EGFR mutations. Methods: Three scientific databases, PubMed, Cochrane library and ClinicalTrials.gov were searched for relevant articles up until 30 June 2024. Progression-free survival (PFS), overall survival (OS), objective response rate (ORR) and ≥3 grade adverse events (AE) were the outcomes of interest. Results: Five clinical trials were included in this systematic review, reporting data from 1124 patients (safety population; n = 1091 efficacy population), who received amivantamab as a monotherapy or in combination with other treatments, both in a first-line and in a relapsed/refractory setting. The median PFS for groups of patients that received amivantamab ranged from 4.3 to 8.3 months, while the lowest observed OS was 10.2 months. The ORR ranged from 30% to 73%. The rate of grade 3 or higher AEs ranged from 35% to 92%, while serious AEs ranged from 29% to 52%. Infusion-related reactions (IRRs) ranged from 42% to 78% among patients that received amivantamab intravenously, while a 13% IRR rate was found in a group of patients that received amivantamab subcutaneously. Conclusions: Current evidence suggests that amivantamab is an effective treatment option for patients with advanced or metastatic NSCLC with EGFR mutations. Amivantamab-based combinations may prolong survival both in the treatment of naïve patients and those who have progressed on chemotherapy or tyrosine kinase inhibitors.
Insights
Amivantamab shows efficacy in advanced non-small cell lung cancer (NSCLC) with EGFR mutations. This treatment may improve survival for both new and previously treated patients.
Area of Science:
- Oncology
- Pharmacology
- Clinical Trials
Background:
- Non-small cell lung cancer (NSCLC) with EGFR mutations presents a significant therapeutic challenge.
- Targeted therapies are crucial for managing advanced or metastatic NSCLC.
- Amivantamab is an emerging treatment option for this patient population.
Purpose of the Study:
- To systematically review the efficacy and safety of amivantamab in advanced/metastatic NSCLC with EGFR mutations.
- To evaluate progression-free survival (PFS), overall survival (OS), objective response rate (ORR), and adverse events (AEs).
Main Methods:
- Systematic literature search of PubMed, Cochrane library, and ClinicalTrials.gov up to June 30, 2024.
- Inclusion of five clinical trials involving 1124 patients.
- Analysis of amivantamab as monotherapy or combination therapy in first-line and relapsed/refractory settings.
Main Results:
- Median PFS ranged from 4.3 to 8.3 months; lowest OS observed was 10.2 months.
- Objective response rates (ORR) varied from 30% to 73%.
- Grade ≥3 adverse events (AEs) occurred in 35-92% of patients; serious AEs in 29-52%. Intravenous amivantamab had higher infusion-related reactions (42-78%) than subcutaneous (13%).
Conclusions:
- Amivantamab demonstrates effectiveness as a treatment for advanced/metastatic NSCLC with EGFR mutations.
- Amivantamab-based combinations show potential to extend survival in both treatment-naïve and pre-treated patients.
- Further research into optimizing amivantamab administration and managing AEs is warranted.
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