Abstract 656P
Background
Amivantamab, an EGFR mesenchymal–epithelial transition factor bispecific antibody, demonstrated superior efficacy in combination with carboplatin plus pemetrexed (CP) as 1L tx versus CP in pts with NSCLC with activating EGFR exon20ins (Zhou et al. NEJM 2023). Here we seek to characterize RW tx patterns and adjusted effectiveness vs 1L amivantamab + CP in a RW pt population.
Methods
In this retrospective, observational study, routinely collected data from 2010 to 2023 were pooled from 4 databases (NCRAS England, ESME France, and COTA, Concert AI US). Pts aged ≥ 18 years with locally advanced/metastatic NSCLC, without prior systemic tx, with ECOG PS 0-1 (when available), and confirmed exon20ins were included. Objectives were to describe 1L tx patterns and outcomes, and compare time to next tx (TTNT; as a proxy for progression-free survival) and overall survival (OS) of amivantamab + CP (from PAPILLON) vs RW tx options (alternatives to platinum (P)-based chemotherapy) using inverse probability weighting of the average tx effect in the treated (IPW-ATT) adjustment for potential confounders.
Results
A total of 232 RW pts were included in the analysis. Median follow-up was 50.5 months; 65.5% of pts were female, 57.8% were aged > 65 years, 40.5% reported a history of smoking, 40.1% had ≥ 3 metastasis locations, 21.6% had liver metastases (mets), and 30.2% had brain mets. Observed 1L txs were: P-based chemotherapies (31.5%), P + immunotherapy (IO) (24.1%), EGFR TKI alone (15.5%), IO alone (9.1%), or other txs (19.8%). Amivantamab + CP demonstrated better comparative effectiveness (TTNT and OS) vs RW txs other than P-based chemotherapy (Table).
Conclusions
In RW practice, P-based chemotherapies were the most commonly used 1L tx in NSCLC pts with EGFR exon20ins. 1L amivantamab + CP demonstrated superior effectiveness vs other commonly used RW txs Table: 656P
Tx outcomes with 1L amivantamab + CP vs 1L RW tx
| TTNT | OS | ||||||
| N | Median, months (95% CI) | HR (95% CI) | p | Median, months (95% CI) | HR (95% CI) | p | |
| Amivantamab + CP vs: | 153 | 17.7 (13.5-NE) | NE (NE-NE) | ||||
| Pooled RW txa | 232 | 9.5 (7.9-11.4) | 0.39 (0.27-0.55) | < 0.001 | 23.7 (15.7-28.2) | 0.52 (0.32-0.86) | 0.011 |
| P + IOb | 56 | 9.4 (7.2-11.8) | 0.38 (0.23-0.60) | < 0.001 | 18.1 (13.5-26.8) | 0.43 (0.23-0.81) | 0.009 |
| EGFR TKIb | 36 | 7.1 (1.9-11.4) | 0.33 (0.17-0.64) | < 0.001 | 18.6 (7.0-31.1) | 0.38 (0.19-0.77) | 0.008 |
| IOc | 21 | 4.8 (3.0-9.5) | 0.31 (0.18-0.55) | < 0.001 | 19.8 (6.1-32.9) | 0.40 (0.20-0.81) | 0.011 |
Adjusted with IPW-ATT for a) age, sex, ECOG, smoking, brain and liver mets; b) age, ECOG, brain and liver mets; c) unadjusted; small sample size. NE, not estimable.
.Clinical trial identification
Editorial acknowledgement
Writing assistance was provided by Larissa Belova, PhD, of Parexel.
Legal entity responsible for the study
Janssen Pharmaceutica N.V.
Funding
Janssen Pharmaceutica N.V.
Disclosure
C. Chouaid: Financial Interests, Personal, Advisory Board: AZ, BI, GSK, Roche, Sanofi Aventis, BMS, MSD, Lilly, Novartis, Pfizer, Takeda, Bayer, Janssen and Amgen; Financial Interests, Institutional, Funding: AZ, BI, GSK, Roche, Sanofi Aventis, BMS, MSD, Lilly, Novartis, Pfizer, Takeda, Bayer, Janssen and Amgen. L. Bosquet: Financial Interests, Institutional, Full or part-time Employment, In charge of scientific projects at Unicancer, Health Data and Partnership Department: Unicancer. Z. Li: Financial Interests, Personal, Research Funding: Hansoh; Financial Interests, Personal, Speaker, Consultant, Advisor: AstraZeneca, Roche, Pfizer. M. Schaeffer, C. Schioppa, N. Perualila, J. Diels: Financial Interests, Personal, Full or part-time Employment: Janssen. X. Lin: Financial Interests, Personal, Full or part-time Employment: Johnson and Johnson; Financial Interests, Personal, Stocks or ownership: Johnson and Johnson. E. Quintero: Financial Interests, Personal, Full or part-time Employment: Janssen. A. Greystoke: Financial Interests, Personal, Speaker, Consultant, Advisor: Amgen, AstraZeneca, Boehringer-Ingelheim, Bristol Myers Squibb, Eli Lilly, Janssen/Johnson & Johnson, MSD, Novartis, Pfizer, Roche, Takeda. All other authors have declared no conflicts of interest.