Abstract 65P
Background
Epidermal growth factor receptor mutations (EGFRm) are present in ~19–24% of patients with non-small cell lung cancer (NSCLC). The US Food and Drug Administration (FDA) approved amivantamab (AMI) on 5/21/2021 for patients with EGFR exon 20 insertions (Exon20Ins) advanced NSCLC who progressed after platinum-based chemotherapy (PBC), on 3/1/2024 for first-line (1L) EGFR Exon20Ins, and for 1L (8/20/2024) and second-line (2L) (9/19/2024) EGFR exon 19 deletion and L858R. Immunotherapy (IO) monotherapy (mono) has shown limited effectiveness in EGFRm advanced NSCLC and when used with PBC, IOs increase toxicity risk without adding therapeutic benefit. This study describes real-world treatment patterns among patients receiving AMI.
Methods
Komodo Research Data closed claims (1/1/2016–10/31/2023)were used to analyze adults with a lung cancer diagnosis (ICD-10-CM: C34) initiated on AMI on/after 5/21/2021 in 2L or later (2L+) for advanced NSCLC. Treatment patterns, including prior IO use with/without PBC, were described for patients initiating AMI in 2L, third-line (3L), and fourth-or-later line (4L+).
Results
A total of 126 patients initiated AMI in 2L+ (mean age: 60.2 years; 63.5% female), with 51.6% receiving AMI in 2L, 32.5% in 3L, and 15.9% in 4L+. For patients initiating AMI in 2L, median follow-up duration was 6.5 months (3L: 5.9; 4L+: 6.8), with a median AMI line of therapy duration of 6.2 months (3L: 4.0; 4L+: 5.2; Table). AMI mono was used in 92.3% of 2L patients (3L: 73.2%; 4L+: 80.0%). Prior PBC use was observed in 83.1% of 2L AMI patients (3L: 100.0%; 4L+: 100.0%); 60.0% had prior IO use (3L: 63.4%; 4L+: 85.0%), including 53.8% IO+PBC (3L: 53.7%; 4L+: 60.0%) and 3.1% IO mono (3L: 4.9%; 4L+: 20.0%).
Table 65P| 2L (n=65) | 3L (n=41) | 4L+ (n=20) | |
| Median follow-up, months | 6.5 | 5.9 | 6.8 |
| Median duration of line of therapy, months | 6.2 | 4.0 | 5.2 |
| AMI mono, % | 92.3 | 73.2 | 80.0 |
| Prior PBC use, % | 83.1 | 100.0 | 100.0 |
| Prior IO use, % | 60.0 | 63.4 | 85.0 |
| With PBC | 53.8 | 53.7 | 60.0 |
| Mono | 3.1 | 4.9 | 20.0 |
Conclusions
Among patients receiving AMI in 2L+, most initiated AMI mono after PBC, consistent with the FDA approval at the time of this study. More than half of patients had prior IO use, exposing them to suboptimal treatment and avoidable toxicity risk.
Legal entity responsible for the study
Janssen Scientific Affairs, LLC, a Johnson & Johnson company.
Funding
Janssen Scientific Affairs, LLC, a Johnson & Johnson company.
Disclosure
D.M. Waterhouse: Financial Interests, Personal, Speaker’s Bureau: Amgen, AZTherapies, Bristol Myers Squibb, EMD Serono, Fresenius Kbi, Janssen Scientific Affairs, LLC, a Johnson & Johnson company, Merck; Financial Interests, Personal, Other, Personal consulting fees: Amgen, Astellas Pharma, AZTherapies, Bristol Myers Squibb, Eisai, Fresenius Kbi, Gilead Sciences, Janssen Scientific Affairs, LLC, a Johnson & Johnson company, Lilly, Merck, Mirati Therapeutics, Novartis, Pfizer, Regeneron/Sanofi, Takeda. I. Lin: Financial Interests, Institutional, Full or part-time Employment: Janssen Scientific Affairs, LLC, a Johnson & Johnson company; Financial Interests, Institutional, Stocks/Shares: Janssen Scientific Affairs, LLC, a Johnson & Johnson company. L. Morrison: Financial Interests, Institutional, Full or part-time Employment, I am an employee of Analysis Group, Inc., a consulting company that has provided paid consulting services to Janssen Scientific Affairs, LLC: Analysis Group, Inc. B. Emond: Financial Interests, Institutional, Full or part-time Employment, I am an employee of Analysis Group, Inc., which has provided paid consulting services to Janssen Scientific Affairs, LLC: Analysis Group, Inc. M. Lafeuille: Financial Interests, Institutional, Full or part-time Employment, I am an employee of Analysis Group, Inc., which has provided paid consulting services to Janssen Scientific Affairs, LLC: Analysis Group, Inc. Y. Wang: Financial Interests, Personal, Full or part-time Employment, I am an employee of Analysis Group, Inc., which has provided paid consulting services to Janssen Scientific Affairs, LLC: Analysis Group, Inc. L. Diaz: Financial Interests, Institutional, Full or part-time Employment, I am an employee of Analysis Group, Inc., which has provided paid consulting services to Janssen Scientific Affairs, LLC: Analysis Group, Inc. P. Lefebvre: Financial Interests, Institutional, Full or part-time Employment, I am an employee of Analysis Group, Inc., which has provided paid consulting services to Janssen Scientific Affairs, LLC: Analysis Group, Inc. D. Waters: Financial Interests, Institutional, Full or part-time Employment: Janssen Scientific Affairs, LLC, a Johnson & Johnson company; Financial Interests, Institutional, Stocks/Shares: Janssen Scientific Affairs, LLC, a Johnson & Johnson company.