KEY TAKEAWAYS
- The phase II trial aimed to develop a simpler method to prevent amivantamab infusion-related reactions.
- Pts with EGFR mutation-positive and KPS <2 received oral dex before ami to prevent infusion-related reactions.
- The study found Oral dex premedication prevented all-grades infusion reactions in ami, requiring confirmation in a larger study.
Amivantamab(Ami) showed promising efficacy in CHRYSALIS-1 and CHRYSALIS-2, but infusion-related reactions were frequent. Ami is available in Singapore, but lazertinib (laz) is unavailable in South Asia. Researchers aimed to develop a simpler method to prevent amivantamab infusion-related reactions.
The study managed seven consecutive advanced lung cancer pts receiving ami treatment from August 2021 to Jan 2023. They followed ami product insert guidelines for infusion day pre-medication. All pts had EGFR mutations, were treatment-refractory with KPS <2, and had previously tolerated EGFR Tyrosine Kinase Inhibitors (TKI) and ami during TKI rechallenge. Pts 5-7 received oral dexamethasone (8mg BD) for three days, starting two days before ami, due to >Grade 3 infusion reactions observed in pts 3-4. Statistical analysis using the Fisher exact test assessed the significance of differences in infusion-related reaction incidence between pts who received pre-infusion day steroids and those who did not.
None of the five experienced infusion-related reactions in pts with pre-infusion day steroids, compared to 2 out of 2 without pre-infusion day steroids. These reactions were severe (Grade 3 or higher), and the difference was statistically significant (P= 0.0476). Patient 4 remained reaction-free from Doses 2 to 6 after receiving pre-infusion day dexamethasone.
The study found oral dex premedication prevented all-grades infusion reactions in ami, requiring confirmation in a larger study.
Source: https://ascopubs.org/doi/abs/10.1200/JCO.2023.41.16_suppl.e21083#
Clinical Trial: https://clinicaltrials.gov/study/NCT05663866
Daniel Boon Yeow Chan. DOI: 10.1200/JCO.2023.41.16_suppl.e21083 Journal of Clinical Oncology 41, no. 16_suppl (June 01, 2023) e21083-e21083.
