How to treat adverse reactions caused by Amivantamab?

Introduction: Amivantamab is a fully human bispecific antibody that targets epidermal growth factor receptor (EGFR) and mesenchymal epithelial transition factor (MET), inhibits ligand-dependent receptor activation, promotes cell surface receptor downregulation, and induces Fc-dependent phagocytosis and antibody-dependent cytotoxicity.

Adverse reactions caused by Amivantamab

The most common adverse reactions include rash, nausea, vomiting, fatigue, edema, paronychia, musculoskeletal pain, dyspnea, stomatitis, cough, constipation, as well as infusion-related reactions, eye toxicity, etc. In addition to the adverse reactions listed above, the most common grade 3 or 4 laboratory adverse reactions include lymphopenia, decreased albumin, decreased phosphate, decreased potassium, increased alkaline phosphatase, increased glucose, increased gamma-glutamyl transferase, and decreased sodium.

Before using evantumumab, patients should discuss potential and precautions in detail with their doctor to ensure safe and effective treatment.

How to treat adverse reactions of Amivantamab

1. Rash: It is recommended that patients keep their skin clean, avoid scratching the rash, and avoid using irritating care products. They can apply topical calamine lotion and other drugs to relieve itching symptoms.

2. Paronychia: Try to keep your hands and feet clean and dry. When in contact with water, soap, solvents and other irritants, you should try to wear gloves for protection to protect the integrity of the periungual skin.

3. Musculoskeletal pain: You can try to reduce the amount of activity, use analgesics such as ibuprofen as directed by your doctor to relieve pain, and maintain adequate rest.

4. Ocular toxicity: Depending on the severity of the condition, evantumumab can be suspended, reduced in dose, or permanently discontinued.

5. Infusion-related reactions: When infusion-related reactions occur, the infusion should be interrupted, and the infusion rate should be reduced or evantumumab should be permanently discontinued depending on the severity of the disease.

6. Pneumonia: Pay attention to monitoring for new or worsening symptoms of interstitial lung disease. Immediately discontinue evantumumab in patients with suspected interstitial pneumonia. If interstitial pneumonia is confirmed, evantumumab will be permanently discontinued.

When using evantumumab, patients should closely monitor adverse reactions and communicate with their doctors in a timely manner when the above symptoms occur so that appropriate treatment measures can be taken.

Effectiveness of evantumumab

Based on the results of a multi-center, non-randomized, open-label, multi-cohort clinical trial, the FDA accelerated approval of evantumumab on May 21, 2021, for the treatment of patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) with EGFR exon 20 insertion mutations, whose disease has progressed during or after platinum-based chemotherapy. The study showed that the overall response rate (ORR) of patients was 40%, and the median duration of response (DOR) was 11.1 months.

Evantumumab is the first bispecific antibody approved for the treatment of solid tumors, entering a market that offers multiple existing anti-EGFR mAb therapies.