- Cho, Byoung Chul;
- Kim, Dong-Wan;
- Spira, Alexander I;
- Gomez, Jorge E;
- Haura, Eric B;
- Kim, Sang-We;
- Sanborn, Rachel E;
- Cho, Eun Kyung;
- Lee, Ki Hyeong;
- Minchom, Anna;
- Lee, Jong-Seok;
- Han, Ji-Youn;
- Nagasaka, Misako;
- Sabari, Joshua K;
- Ou, Sai-Hong Ignatius;
- Lorenzini, Patricia;
- Bauml, Joshua M;
- Curtin, Joshua C;
- Roshak, Amy;
- Gao, Grace;
- Xie, John;
- Thayu, Meena;
- Knoblauch, Roland E;
- Park, Keunchil
Patients with epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer (NSCLC) often develop resistance to current standard third-generation EGFR tyrosine kinase inhibitors (TKIs); no targeted treatments are approved in the osimertinib-relapsed setting. In this open-label, dose-escalation and dose-expansion phase 1 trial, the potential for improved anti-tumor activity by combining amivantamab, an EGFR-MET bispecific antibody, with lazertinib, a third-generation EGFR TKI, was evaluated in patients with EGFR-mutant NSCLC whose disease progressed on third-generation TKI monotherapy but were chemotherapy naive (CHRYSALIS cohort E). In the dose-escalation phase, the recommended phase 2 combination dose was established; in the dose-expansion phase, the primary endpoints were safety and overall response rate, and key secondary endpoints included progression-free survival and overall survival. The safety profile of amivantamab and lazertinib was generally consistent with previous experience of each agent alone, with 4% experiencing grade ≥3 events; no new safety signals were identified. In an exploratory cohort of 45 patients who were enrolled without biomarker selection, the primary endpoint of investigator-assessed overall response rate was 36% (95% confidence interval, 22-51). The median duration of response was 9.6 months, and the median progression-free survival was 4.9 months. Next-generation sequencing and immunohistochemistry analyses identified high EGFR and/or MET expression as potential predictive biomarkers of response, which will need to be validated with prospective assessment. ClinicalTrials.gov identifier: NCT02609776 .