COPERNICUS Longer-Term Safety and On-Target Adverse Events

Elizabeth Dennis, MSN, APRN, FNP-C, reviews longer follow-up safety data from the COPERNICUS study and links the adverse events of amivantamab plus lazertinib to their mechanisms in epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer. She finds adverse event and discontinuation rates encouraging, with low rates of administration-related reactions, venous thromboembolism (VTE), and severe rash. Ms. Dennis reports a 1-year rate of discontinuation due to selected adverse events of less than 1% in COPERNICUS vs 9% in MARIPOSA, cautioning that this cross-trial comparison involves a single-arm study with shorter follow-up. She suggests subcutaneous dosing and proactive supportive care may help reduce these toxicities. Ms. Dennis explains that amivantamab, a bispecific antibody targeting EGFR and mesenchymal-epithelial transition (MET), and lazertinib, a third-generation tyrosine kinase inhibitor, together broaden EGFR inhibition and address resistance. Because skin and nail beds express EGFR, rash, nail toxicity, dry skin, and paronychia reflect on-target effects, and VTE risk warrants prophylactic anticoagulation during the first 4 months.