MARIPOSA-2：奥希替尼后进展的 EGFR 突变 NSCLC 中 Amivantamab + 化疗

类型: 论文 发表日期: 2024-01 入库日期: 2026-05-21 来源: Annals of Oncology / FDA 标签: EGFR L858R, 奥希替尼耐药, Amivantamab, 化疗, MARIPOSA-2, 二线治疗

Citation

Passaro A, Wang J, Wang Y, et al. Amivantamab plus chemotherapy with and without lazertinib in EGFR-mutant advanced NSCLC after disease progression on osimertinib: primary results from the phase III MARIPOSA-2 study. Annals of Oncology. 2024. DOI: 10.1016/j.annonc.2023.10.117

FDA approval note: FDA approves amivantamab-vmjw with carboplatin and pemetrexed for EGFR exon 19 deletions or L858R after EGFR TKI

Why this is in CCL

This is directly relevant if mom’s disease is judged to have progressed on or after osimertinib. It is one of the major post-osimertinib randomized trials for EGFR exon 19 deletion/L858R NSCLC.

Key takeaways

• Population: EGFR exon 19 deletion or L858R advanced NSCLC after progression on osimertinib.
• Arms included amivantamab + carboplatin/pemetrexed, chemotherapy alone, and amivantamab/lazertinib/chemotherapy.
• FDA approval in September 2024 covers amivantamab + carboplatin/pemetrexed after EGFR TKI progression.
• The ScienceDirect abstract reports higher response rates for amivantamab-chemotherapy combinations than chemotherapy alone.

Practical relevance

• A concrete option to discuss if standard osimertinib plus chemo loses control.
• Because mom already receives platinum/pemetrexed and has marrow suppression, risk/benefit should focus on whether adding amivantamab offers enough incremental benefit.
• Infusion reactions, rash, nail toxicity, thrombosis risk, and cytopenias should be part of the question list.