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Overall Survival with Amivantamab-Lazertinib in

The New England journal of medicine2025-09-09PubMed
Total: 88.5Innovation: 8Impact: 0Rigor: 0Citation: 0

Summary

In this phase 3 randomized trial, amivantamab-lazertinib significantly improved overall survival versus osimertinib (HR 0.75; 95% CI 0.61–0.92) with 3-year OS 60% vs 51%. Grade ≥3 adverse events were more frequent with amivantamab-lazertinib (80% vs 52%), notably skin events, venous thromboembolism, and infusion reactions.

Key Findings

  • Overall survival was significantly longer with amivantamab-lazertinib versus osimertinib (HR 0.75; P=0.005).
  • Three-year overall survival: 60% vs 51% (amivantamab-lazertinib vs osimertinib).
  • Grade ≥3 adverse events were more frequent with amivantamab-lazertinib (80% vs 52%), especially skin-related events, venous thromboembolism, and infusion reactions.
  • At data cutoff, ongoing treatment rates were 38% vs 28% (amivantamab-lazertinib vs osimertinib).

Clinical Implications

If adopted, therapy selection may shift toward amivantamab-lazertinib in the first-line setting, with proactive monitoring and management of skin toxicity, venous thromboembolism, and infusion reactions.

Why It Matters

Demonstrates an overall survival advantage of a novel combination targeted regimen over the current standard comparator in previously untreated patients, representing a potential change in first-line therapy.

Limitations

  • Higher toxicity with amivantamab-lazertinib may limit tolerability for some patients.
  • Abstract lacks detail on subgroup biomarker stratification and quality-of-life outcomes.

Future Directions

Define biomarker-driven subgroups benefiting most from amivantamab-lazertinib, optimize toxicity mitigation strategies, and assess quality-of-life and cost-effectiveness.

Study Information

Study Type
RCT
Research Domain
Treatment
Evidence Level
I - Randomized phase 3 trial with overall survival endpoint.
Study Design
OTHER