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2023 Targeted Therapies of Lung Cancer Meeting (Po ...
P1.32. Durable Complete Response in Leptomeningeal ...
P1.32. Durable Complete Response in Leptomeningeal Disease (LMD) of EGFR Mutated Non-Small Cell Lung Cancer (NSCLC) to Amivantamab, an EGFR-MET Receptor Bispecific Antibody, After Progressing on Osimertinib
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A case study presented at the IASLC 2023 Targeted Therapies of Lung Cancer Meeting highlights the potential of amivantamab, a bispecific antibody targeting EGFR and MET receptors, in the treatment of CNS involvement in non-small cell lung cancer (NSCLC) patients with EGFR mutations. The patient in the case had an atypical EGFR mutation and initially received osimertinib, but experienced disease progression and leptomeningeal disease (LMD). However, after starting amivantamab monotherapy, the patient showed a significant response with a complete resolution of CNS disease and durable responses in the primary lung lesion.<br /><br />Amivantamab is currently approved for locally advanced metastatic NSCLC patients with EGFR exon 20 insertion after platinum-based chemotherapy. Its role in patients with CNS involvement or other EGFR mutation subtypes is still unclear. This case study adds to the growing evidence of the potential benefit of amivantamab in treating CNS metastases or rare EGFR mutations that have progressed on conventional tyrosine kinase inhibitors (TKIs). The patient experienced a drastic improvement in functional status and has been on amivantamab for more than 14 months with no evidence of CNS disease.<br /><br />Previously, amivantamab was thought to have limited clinical benefit to CNS metastases due to poor blood-brain barrier penetration. However, this case suggests that it can lead to a durable complete response in CNS disease. Further studies are needed to explore the clinical utility of amivantamab monotherapy in treating patients with CNS metastases or other rare EGFR mutations who have progressed on conventional TKIs.<br /><br />References:<br /><br />1. Petrini I, Giaccone G. Amivantamab in the Treatment of Metastatic NSCLC: Patient Selection and Special Considerations. Onco Targets Ther. 2022 Oct 12;15:1197-1210.<br /><br />2. Park K, Haura EB, Leighl NB, et al. Amivantamab in EGFR Exon 20 Insertion-Mutated Non-Small-Cell Lung Cancer Progressing on Platinum Chemotherapy: Initial Results From the CHRYSALIS Phase I Study. J Clin Oncol. 2021 Oct 20;39(30):3391-3402.<br /><br />3. Nagasaka M, Balmanoukian AS, Madison R, et al. Amivantamab (JNJ-61186372) induces clinical, biochemical, molecular, and radiographic response in a treatment-refractory NSCLC patient harboring amplified triple EGFR mutations (L858R/ T790M/G796S) in cis. Lung Cancer. 2022 Feb;164:52-55.
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Yoonhee Choi, New York-Presbyterian of Queens, United States
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Speaker
Yoonhee Choi, New York-Presbyterian of Queens, United States
Topic
Poster Listing
Keywords
amivantamab
bispecific antibody
EGFR
MET receptors
CNS involvement
NSCLC
osimertinib
leptomeningeal disease
complete resolution
CNS metastases
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