Current Treatments and New Combinations in EGFR-Mutant Lung Cancer

Current treatment options for EGFR-mutant lung cancer include oral therapy combinations with chemotherapy and emerging combination regimens like the chemo-free MARIPOSA regimen, according to Dr. Nicolas Girard, who added that advances in subcutaneous delivery allow for less frequent, more convenient dosing while maintaining high efficacy.

Girard is a professor of medicine and physician at Institut Curie in Paris. He is affiliated with the Institut du Thorax and serves as head of the Department of Medical Oncology.

Transcript

Can you explain the current treatment options for patients with EGFR-mutant lung cancer, including emerging combination regimens and advances in drug delivery methods?

In EGFR-mutant lung cancer, we have several options. We have TKIs, which are oral pills like Tagrisso (osimertinib). We have TKI plus chemotherapy, which is more intensive. We also have the combination of Rybrevant (amivantamab-vmjw) plus Lazcluze (lazertinib), which is an oral pill plus an injection. It is not chemotherapy; it's actually a targeted agent that is administered through infusion.

What we call the MARIPOSA regimen with Rybrevant plus Lazcluze is chemo-free, and the efficacy of this regimen is actually quite similar to that of chemotherapy plus the TKI. It means that we can do better than only a pill in this situation with some combination, either with chemotherapy, which is probably more aggressive with chemotherapy-related toxicities, or chemo-free.

In the PALOMA-2 trial, we adapted the MARIPOSA regimen to deliver the pill plus a subcutaneous injection of Rybrevant. Subcutaneous is actually easier than intravenous because it allows us to deliver the drug only every four weeks. As [the data] showed, we show the efficacy of subcutaneous every four weeks plus the daily oral pill. And the efficacy is actually similar to the intravenous every two weeks plus the oral pill. It means that we can really adapt the delivery of this combination with similar efficacy and a high response rate. It works in more than 80% of the patients.

We do not yet have the duration of response and those kinds of things, because these are really early data, but it's important data because we can implement that in the clinic. When Rybrevant subcutaneous is available, we can implement the dosing every four weeks, which obviously facilitates the life of everyone because it means coming to the hospital only every four weeks, and it can also be administered at home, so it really facilitates the delivery of the treatment with a similar efficacy.

Transcript has been edited for clarity and conciseness.

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