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Poster Display session

27P - Amivantamab versus alternative real-world anti-cancer therapies in patients with advanced non-small cell lung cancer with epidermal growth factor receptor exon 20 insertion mutations in the US and Europe

Date

31 Mar 2023

Session

Poster Display session

Presenters

Nicolas Girard

Citation

Journal of Thoracic Oncology (2023) 18 (4S): S35-S88.
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Authors

N. Girard1, J. Wolf2, T.M. Kim3, N. Leighl4, C. Knott5, T. Li6, J. Cabrieto6, J. Diels7, J. Sermon8, P. Mahadevia9, C.A. Schioppa10, J. Sabari11

Author affiliations

  • 1 Institut Curie, Paris/FR
  • 2 University Hospital of Cologne, Cologne/DE
  • 3 Seoul National University Hospital, Seoul/KR
  • 4 Princess Margaret Cancer Centre, Toronto/CA
  • 5 Public Health England, London/GB
  • 6 Janssen Pharmaceuticals, Raritan/US
  • 7 Janssen Pharmaceutica NV - Belgium, Beerse/BE
  • 8 Janssen Pharmaceutica NV - Belgium, 2340 - Beerse/BE
  • 9 Janssen R&D, 08869 - Spring House/US
  • 10 Janssen Pharmaceutica NV, Beerse/BE
  • 11 New York University Langone Health, New York/US

Resources

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Abstract 27P

Background

Amivantamab was the first approved therapy for advanced/metastatic NSCLC harboring EGFR exon 20 insertion mutations (Ex20ins) who progressed on platinum chemotherapy (CT). Since Ex20ins is uncommon, it may be confused with activating EGFR mutations resulting in treatment with limited benefit. This study estimates the relative effectiveness of amivantamab versus alternative anti-cancer treatments used in real-world settings for NSCLC with Ex20ins.

Methods

Data from the single-arm CHRYSALIS trial were compared to an external cohort of patients derived from six US and European real-world data sources that met the CHRYSALIS Cohort D+ eligibility criteria. Amivantamab was compared to EGFR TKIs including osimertinib, immunotherapy, non-platinum CT, VEGFi + CT, and others. Patient-level data were used to adjust for differences in prognostic factors using inverse probability weighting (average treatment effect among the treated). Binary and time-to-event endpoints were analyzed using weighted logistic regression and proportional hazards regression, respectively.

Results

After adjustment, baseline characteristics between the two cohorts were balanced. For all individual treatment class comparisons, results were consistently in favor of amivantamab in overall survival (OS), progression free survival (PFS), time to next treatment (TTNT), and overall response rate by investigator (ORR-INV) (see table). Compared to osimertinib, amivantamab provided a significant advantage in ORR-INV (36.8% vs 0%), OS (HR [95% CI]: 0.37 [0.19, 0.73]) and TTNT (HR [95% CI]: 0.55 [0.31, 0.98]).

Table: 27P
TreatmentAdjusted Hazard Ratio (95% CI) for amivantamab vs. other treatment
NORR-INVOSPFS-INVTTNT
Amivantamab11436.8%
All EGFR TKIs695.3%0.46 (0.30, 0.72)0.51 (0.34, 0.76)0.38 (0.26, 0.55)
Osimertinib subgroup220.0%0.37 (0.19, 0.73)0.67 (0.33, 1.37)^0.55 (0.31, 0.98)
Immunotherapy9113.2%0.40 (0.27, 0.60)0.42 (0.31, 0.58)0.41 (0.29, 0.57)
Non-platinum chemotherapy8718.1%0.45 (0.29, 0.70)0.52 (0.36, 0.76)0.36 (0.25, 0.53)
VEGFi + chemotherapy5721.4%^0.54 (0.34, 0.85)0.60 (0.42, 0.87)0.53 (0.35, 0.79)
Other7927.2%^0.58 (0.36, 0.92)0.61 (0.43, 0.87)0.51 (0.35, 0.75)
^

No statistically significant difference vs. amivantamab; all other values significant.

Conclusions

Based on this adjusted treatment comparison, amivantamab provides significant benefits compared to alternative therapies used in real world practice. Education on appropriate treatment choice is important to advance quality of cancer care.

Editorial acknowledgement

The authors acknowledge Heather Burnett of Evidera, a ThermoFisher company, for medical writing and ediotrial assistance based on the author's input and direction.

Legal entity responsible for the study

The authors.

Funding

Janssen.

Disclosure

N. Girard: Financial Interests, Personal, Invited Speaker: AstraZeneca, BMS, MSD, Roche, Pfizer, Mirati, Amgen, Novartis, Sanofi; Financial Interests, Personal, Advisory Board: AstraZeneca, BMS, MSD, Roche, Pfizer, Janssen, Boehringer Ingelheim, Novartis, Sanofi, AbbVie, Amgen, Eli Lilly, Grunenthal, Takeda, Owkin; Financial Interests, Institutional, Research Grant, Local: Roche, Sivan, Janssen; Financial Interests, Institutional, Funding: BMS; Non-Financial Interests, Personal, Officer, International Thymic malignancy interest group, president: ITMIG; Other, Personal, Other, Family member is an employee: AstraZeneca. J. Wolf: Financial Interests, Personal, Advisory Board: Amgen, AstraZeneca, Blueprint, BMS, Boehringer Ingelheim, Daiichi Sankyo, Ignyta, Janssen, Eli Lilly, Loxo, MSD, Novartis, Pfizer, Roche, Seattle Genetics, Takeda; Financial Interests, Personal, Invited Speaker: Bayer, Chugai; Financial Interests, Institutional, Research Grant: BMS, Janssen, Novartis, Pfizer. T.M. Kim: Non-Financial Interests, Personal, Advisory Board: AstraZeneca, Janssen, Regeneron, Takeda; Financial Interests, Personal, Invited Speaker: AstraZeneca, IMBDx, Inc., Takeda, Yuhan; Financial Interests, Personal, Advisory Role: AstraZeneca, Janssen, Regeneron, Samsung Bioepis, Takeda, Yuhan; Financial Interests, Personal, Research Grant: AstraZeneca-KHIDI; Non-Financial Interests, Institutional, Writing Engagements: AbbVie, AstraZeneca, Bayer, Black Diamond Therapeutics, Blueprint Medicines, Boryung, Bristol Myers Squibb, Celgene, F. Hoffman-La Roche Ltd/Genentech, Inc., Hanmi, Janssen, Novartis, Regeneron, Sanofi; Non-Financial Interests, Institutional, Invited Speaker: Takeda, Yuhan. N. Leighl: Financial Interests, Personal, Other, CME/independent lectures: MSD, BMS, Hoffmann LaRoche, EMD Serono; Financial Interests, Personal, Invited Speaker, independent lectures: Novartis, Takeda; Financial Interests, Personal, Advisory Board: Puma Biotechnology; Financial Interests, Institutional, Research Grant: Amgen, AstraZeneca, Array, Bayer, EMD Serono, Guardant Health, Eli Lilly, MSD, Pfizer, Roche, Takeda. T. Li: Financial Interests, Personal, Stocks/Shares: Janssen; Financial Interests, Personal, Full or part-time Employment: Janssen. J. Cabrieto: Financial Interests, Personal, Stocks/Shares: Janssen; Financial Interests, Personal, Full or part-time Employment: Janssen. J. Diels: Financial Interests, Personal, Stocks/Shares: Janssen; Financial Interests, Personal, Full or part-time Employment: Janssen. J. Sermon: Financial Interests, Personal, Stocks/Shares: Janssen; Financial Interests, Personal, Full or part-time Employment: Janssen. P. Mahadevia: Financial Interests, Personal, Stocks/Shares: Janssen; Financial Interests, Personal, Full or part-time Employment: Janssen. C.A. Schioppa: Financial Interests, Personal, Stocks/Shares: Janssen; Financial Interests, Personal, Full or part-time Employment: Janssen. J. Sabari: Financial Interests, Personal, Advisory Board: AstraZeneca, Genentech, Janssen, Pfizer, Regeneron, Sanofi Genzyme, Takeda, Mirati Therapeutics. All other authors have declared no conflicts of interest.

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