Dual EGFR/MET Targeting and Predictable Toxicities With Amivantamab Plus Lazertinib

Elizabeth Dennis, MSN, APRN, FNP-C, explains the dual-targeting mechanism of amivantamab plus lazertinib in epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer. Amivantamab is a bispecific antibody targeting EGFR and mesenchymal-epithelial transition (MET), and lazertinib is a third-generation tyrosine kinase inhibitor. “Together, they’re designed to provide broader inhibition of EGFR signaling and address mechanisms of resistance that can emerge from EGFR-targeted therapy alone,” she says. Because skin and nail beds express EGFR, rash, nail toxicity, dry skin, and paronychia reflect on-target effects, and venous thromboembolism risk warrants prophylactic anticoagulation for the first 4 months. Ms. Dennis calls these toxicities predictable and stresses patient education, prophylaxis, and early intervention. From longer COPERNICUS follow-up, she reports a 1-year rate of discontinuation due to selected adverse events of less than 1% vs 9% in MARIPOSA, noting this cross-trial comparison involves a single-arm study with shorter follow-up. “As [advanced practice providers], that’s where we can make a real difference in helping our patients stay on treatment and maintain their quality of life,” she says.