Evantuzumab and lazetinib

Amivantamab-vmjw and Lazertinib are two drugs targeting non-small cell lung cancer (NSCLC) that have advantages and potential in the treatment of lung cancer.

Amivantamab (amivantamab-vmjw) is a bispecific antibody directed against the EGFR body and MET receptor, also known asJNJ-6372. The drug is specifically indicated for the treatment of adult patients with locally advanced or metastatic non-small cell lung cancer harboring epidermal growth factor receptor (EGFR) exon 20 insertion mutations. Evantumumab could provide a new treatment option for these patients when chemotherapy has been developed on or after platinum-based agents.

Lazertinib (lazertinib) is an oral third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI). The drug is jointly developed by Yuhan and Janssen Biotech. The characteristic of lazertinib is that it has brain penetration, can irreversibly inhibit EGFR-TKI, and is effective against brain metastasis. For patients with non-small cell lung cancer, lazertinib can target the T790M mutation and activate EGFR mutations Ex19del and L858R while sparing wild-type EGFR.

Preliminary results from the global MARIPOSA study show that evantumumab significantly reduces the risk of disease progression or death compared with the third-generation EGFR inhibitor osimertinib (osimertinib) in patients with untreated non-small cell lung cancer and common EGFR mutations. After 22 months of interim follow-up, 35% of patients who received evantumumab plus lazertinib had disease progression, and 47% of patients who received osimertinib had disease progression.

Although treatment responds wellsome patients may experience disease progression requiring intensive treatment, thereby increasing the risk of further adverse events. Treatment with these EGFR inhibitory therapies often results in off-target effects such as infusion-related reactions and dermatological events, including rash and paronychia, soon after initiation of treatment, usually within the first 4 months. If not managed appropriately and if pre-treatment education is not provided, such adverse events can significantly impact the patient experience, leading to poor treatment compliance, treatment interruption, and discontinuation.

It is worth mentioning that the combination of evantumumab and lazertinib has shown good efficacy and safety in the treatment of non-small cell lung cancer. The combined use of these two drugs can provide better protection for patients with brain metastases, and can also regulate the immune microenvironment and enhance the anti-tumor effect. In clinical trials of patients with osimertinib-resistant EGFR mutated non-small cell lung cancer, the regimen of evantumumab combined with lazertinib showed reliable efficacy and safety.