SubQ Amivantamab Q4W Maintains Efficacy, Improves Convenience: Nicolas Girard, MD, PhD

Subcutaneous amivantamab delivered every 4 weeks (Q4W) provides similar efficacy as the intravenous regimen every 2 weeks but provides the benefit of longer time between doses and a lower risk of adverse events, explained Nicolas Girard, MD, PhD, head of the Medical Oncology Department at Institut Curie in France.

The Q4W regimen also fits better with the needs of patients and the hospital, he added. The results of subcutaneous amivantamab Q4W plus lazertinib in first-line EGFR-mutated advanced non–small cell lung cancer were presented at the 2025 World Lung Cancer Conference, held September 6-9, 2025, in Barcelona, Spain.

This transcript was lightly edited for clarity; captions were auto-generated.

Transcript

Can you elaborate on the pharmacokinetic findings comparing the Q4W subcutaneous regimen with the standard IV dosing in PALOMA-2, and how confidence-inducing are these results for potential clinical adoption?

We see similar pharmacokinetics [PK] for amivantamab [subcutaneous] vs amivantamab intravenous. This was previously shown in the PALOMA-3 randomized trial with ami [amivantamab] plus lazer [lazertinib] in the late-line setting for these patients. Here in this cohort, for patients we treated with amivantamab every 4 weeks in combination with lazertinib in the first-line setting, we see again, a similar PK. It reinforces that the exposure of patients with subcutaneous amivantamab even given every 4 weeks, is actually good and sufficient to provide efficacy. We see that in the clinical data. We clearly see that we have a similar overall response rate in this cohort vs the historic landmark MARIPOSA trial with intravenous amivantamab every 2 weeks—more than 80%, which is very high.

We do not have yet duration of response, PFS [progression-free survival], [and] OS [overall survival], for sure, but it clearly provides data regarding this very long delay between 2 injections of amivantamab that is permitted by the subcutaneous formulation, and that also fits with the patient needs and also the hospital needs. It clearly makes amivantamab a compound that fits with continuation of daily activities, [with] not too much time spent for care. That's really important for those patients with EGFR-mutant non–small cell lung cancer.

We also see that the subcutaneous formulation, and this had been previously shown in our [trial] of course and in the PALOMA-3 trial—that we have a lower risk of adverse events, especially the infusion-related reactions that are very frequent with intravenous [formulation]—while we may reduce that using the SKIPPirr regimen with dexamethasone given for 3 days before injection. Here, with the [subcutaneous], we do not have that.

We also see the efficacy of VTE [venous thromboembolism] prophylaxis that is now part of the MARIPOSA regimen with anticoagulation for the first 4 months of treatment. This was implemented in this PALOMA-2 cohort, and we see a risk of VTE that is below 10%—in line with what we expect in lung cancer patients. In this cohort, we had not implemented the COCOON regimen for the prophylaxis of cutaneous side effects. We now know with the COCOON [trial], and I feel it will also help to reduce the cutaneous side effects.

[It is] very important cohort with this subcutaneous formulation every 4 weeks, we facilitate the administration of the MARIPOSA regimen, which is now the standard of care for the patients with metastatic non–small cell lung cancer with common EGFR mutation. The results of MARIPOSA have been published during the conference in the New England Journal of Medicine.