Precautions and treatment effects of lung cancer drug evantumumab

Introduction: Evantumumab (trade name: Rybrevant, generic name: amivantamab-vmjw) is a targeted drug used to treat certain types of non-small cell lung cancer (NSCLC). It is a humanized EGFR + c-Met bispecific antibody drug that blocks EGFR and MET-mediated signaling and guides immune cells to target tumors carrying activating and resistant EGFR/MET mutations and amplifications. This article mainly talks about the precautions, administration methods, treatment effects, storage methods, etc. of evantumumab.

Notes

1. Infusion-related reaction (IRR): The infusion should be interrupted immediately at the first sign of an infusion-related reaction. Reduce the infusion rate or permanently discontinue evantumumab based on severity.

2. Interstitial lung disease (ILD)/pneumonia: Patients need to be closely monitored for new or worsening symptoms of ILD. In hospitalized patients with suspected ILD/pneumonitis, evantumumab infusion should be discontinued immediately. If ILD/pneumonitis is confirmed, permanently discontinue treatment.

3. Adverse skin reactions: May cause rashes, including acneiform dermatitis and toxic epidermal necrolysis. Depending on the severity of the skin adverse reactions, discontinuation, dose reduction, or permanent discontinuation of evantumumab may be necessary.

4. Ocular toxicity: Refer patients with worsening eye symptoms to an ophthalmologist promptly. Depending on the severity, evantumumab may need to be discontinued, dose reduced, or permanently discontinued.

5. Embryo-fetal toxicity: Evantumumab may cause fetal damage. Women are advised to use effective contraceptive measures.

Administration

Evantumumab is administered as an intravenous infusion after dilution based on baseline body weight. For patients weighing <80kg, the recommended dose is 1050 mg; for patients weighing ≥80kg, the recommended dose is 1400 mg. Evantumumab was administered via peripheral lines during weeks 1 and 2, with weekly infusions for 4 weeks. The initial dose is given as a divided infusion on Days 1 and 2 of Week 1, then every 2 weeks.

Therapeutic effect

In a clinical trial (NCT02609776), the efficacy of evantumumab in the treatment of patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) with EGFR exon 20 insertion mutations was evaluated. The main efficacy indicator of this study was based on the Response Evaluation Criteria in Solid Tumors (RECIST) v1.1), overall response rate (ORR) as assessed by blinded independent central review (BICR), and another efficacy metric is duration of response (DOR). The objective response rate of evantumumab in the treatment of non-small cell lung cancer is 40%, including the complete response rate: 3.7%; the proportion of patients with disease response time >6 months is 63%.

How to store

should be stored in the refrigerator at 2°C to 8°C (36°F to 46°F). Medicines should be placed in a light-proof environment to avoid adverse effects of light exposure on the medicines. Although evantumumab needs to be kept refrigerated, it should never be frozen. Medications should be stored in a dry environment away from moisture and moisture. Keep medicines out of reach of children to avoid ingestion or misuse.

Before using evantumumab, patients should undergo a detailed medical evaluation, including tumor genetic testing, cardiac function assessment, and liver and kidney function testing. Patients should be monitored regularly during treatment so that any potential adverse reactions can be detected and addressed promptly.