Long-Term Impact of First-Line Amivantamab Plus Lazertinib Versus Osimertinib on Mechanisms of Acquired Resistance in MARIPOSA: A Brief Report.
Hidetoshi Hayashi, Byoung Chul Cho, David R Spigel et al.
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In 30 seconds
The MARIPOSA trial evaluated the long-term effects of first-line amivantamab plus lazertinib compared to osimertinib in patients with EGFR-mutated advanced NSCLC. This randomized controlled trial found that amivantamab-lazertinib significantly improved overall survival (HR: 0.75; p = 0.005) and reduced common resistance mechanisms, leading to a longer median second-line progression-free survival of 8.4 months versus 5.3 months with osimertinib (HR: 0.72; p = 0.02).
Key findings
- MET amplifications were reduced to 3.4% with amivantamab-lazertinib compared to 13.1% with osimertinib (p = 0.002).
- Secondary EGFR mutations occurred in 1.4% of patients receiving amivantamab-lazertinib versus 7.6% with osimertinib (p = 0.01).
- Median second-line progression-free survival was 8.4 months for amivantamab-lazertinib versus 5.3 months for osimertinib (HR: 0.72; p = 0.02).
- Patients with unknown resistance had a median second-line PFS of 7.4 months compared to 4.6 months for those with known resistance (HR: 0.63; p = 0.01).
Why it matters
Understanding the mechanisms of acquired resistance in EGFR-mutated NSCLC is crucial for optimizing treatment strategies. The findings suggest that amivantamab-lazertinib may alter the resistance landscape, potentially leading to improved long-term outcomes.