Amivantamab Plus Lazertinib vs Osimertinib in First-line EGFR-mutant Advanced NSCLC: Longer Follow-up of the MARIPOSA Study
Recommended Citation
Wiesweg M, Gadgeel SM, Cho B, Lu S, Felip E, Hayashi H, Spira A, Besse B, Thomas M, Owen S, Kim Y, Lee S, Mourao J, Lee Y, Zhao Y, Fang Y, Girard N, Liu Z, Sun P, Cunha Souza Oliveira S, Shen H, Paz-Ares L, Matsumoto S, Tanaka H, Ahmad A, Andabekov T, Sunpaweravong P, Özyilkan Ö, Yang J, Gottfried M, Hernandez O, Kimmich M, Cortinovis D, Kaen D. Amivantamab Plus Lazertinib vs Osimertinib in First-line EGFR-mutant Advanced NSCLC: Longer Follow-up of the MARIPOSA Study. 2025; (S1):S51-S52.
Document Type
Conference Proceeding
Publication Date
3-18-2025
Abstract
Introduction: Amivantamab (ami) is an EGFR-MET bispecific antibody with immune cell-directing activity. Lazertinib (laz) is a CNS-penetrant 3rd-generation EGFR TKI. In the primary analysis of the phase 3 MARIPOSA study (NCT04487080), at a median follow-up of 22.0 months, ami plus laz significantly improved progression-free survival (PFS) by blinded independent central review vs osimertinib (osi) in patients with treatment-naïve, EGFR-mutated advanced NSCLC (HR, 0.70; 95 % CI, 0.58-0.85; P < 0.001). Early interim overall survival (OS) analysis showed a favorable trend for ami-laz over osi (HR, 0.80; 95 % CI, 0.61-1.05; P = 0.11). Here, we present updated results with longer follow-up from MARIPOSA. Methods: MARIPOSA randomized 1074 patients with treatment-naïve, EGFRmutated (Exon 19 del or Exon 21 L858R substitutions) locally advanced or metastatic NSCLC 2:2:1 to open-label ami-laz (n = 429), blinded osi (n = 429), or blinded laz (n = 216). This analysis, requested by health authorities, compares ami-laz with osi. Results: At a median follow-upof 31.1 months, 44 % (185/421) and 34 % (145/428) of patients were still on treatment in the ami-laz and osi arms, respectively. In total, 155 patients in the ami-laz arm and 233 in the osi arm had investigator-assessed progressive disease and discontinued treatment. Of those, 72 % (111/155) and 74 % (173/233) initiated subsequent therapy, respectively, with carbo-pem being the most common first subsequent therapy across arms (ami-laz, 26 % [29/111]; osi, 28 % [48/173]). PFS after first subsequent therapy (PFS2) favored ami-laz (HR, 0.73; 95 % CI, 0.59-0.91; nominal P = 0.004). Patients receiving ami-laz demonstrated significantly longer median time to treatment discontinuation and time to subsequent therapy vs osi. Intracranial PFS showed a favorable trend for ami-laz vs osi . While not formally tested for significance, median OS was not estimable for ami-laz vs 37.3 months for osi (HR, 0.77; 95 % CI, 0.61-0.96; nominal P = 0.019). At 24 months, 75 % and 70 % of patients were alive in the ami-laz and osi arms, respectively; corresponding values at 36 months were 61 % and 53 %. Conclusions: Ami-laz continues to show a trend towards improved OS while also improving post-progression outcomes vs osi, reaffirming ami-laz as a firstline standard-of-care for EGFR-mutated advanced NSCLC.
Issue
S1
First Page
S51
Last Page
S52
