Safety Management With Amivantamab Plus Lazertinib in NSCLC

Adverse event (AE) management is a central consideration when combining amivantamab (Rybrevant) and lazertinib (Lazcluze) for patients with EGFR-mutant non–small cell lung cancer (NSCLC), according to Benjamin Besse, MD, PhD.

In an interview with Oncology Nursing News at the 2025 World Conference on Lung Cancer, Besse, director of Clinical Research at Gustave Roussy, highlighted safety strategies evaluated in the phase 1/1b CHRYSALIS-2 trial. He noted that cutaneous toxicities are common with EGFR inhibition, making proactive prevention essential. Protocols with oral antibiotics and topical creams can help reduce the risk and severity of these events.

Toxicities associated with MET inhibition, including edema and low serum albumin, require careful monitoring, though standardized prevention protocols are not established, said Besse.

Thromboembolic events are another concern with the dual blockade. Besse advised that patients receive prophylaxis during the first 4 months of therapy and that clinicians remain vigilant for symptoms such as chest pain or shortness of breath that may indicate clotting.

Transcript

With the combination of amivantamab and lazertinib, we target EGFR with the double blockade and MET. For EGFR, usually the AEs are cutaneous AEs. There, we should be very proactive in preventing the AEs. There is a protocol with oral antibiotics and creams to prevent or reduce the incidence of cutaneous toxicity.

Regarding MET, [a common toxicity is] edema. It can also lower the albumin level in the blood, but there are no specific management protocols for this. You can dose reuse when for each toxicity if it’s too intense.

The combination of the 2 drugs also brings more thromboembolic events. During the first 4 months, you must give a prophylactic treatment for thromboembolic events, and during the course of the disease, always stay tuned that for chest pain, shortness of breath, any unusual symptoms that could be related to a thromboembolic event. Keep that in mind, to have dedicated work.

This transcript has been edited for clarity and conciseness.