Balazs Halmos, MD, reviews findings from COPERNICUS evaluating how subcutaneous amivantamab and proactive supportive care can improve the real-world delivery of amivantamab-lazertinib for advanced EGFR-mutated lung cancer. Building on the efficacy demonstrated in MARIPOSA, the study examines strategies to reduce treatment-related challenges through subcutaneous administration, dermatologic prophylaxis, and preventive anticoagulation. These measures were associated with fewer administration-related reactions, severe skin toxicities, and thromboembolic events, helping make the regimen more manageable for both patients and clinicians. Dr. Halmos emphasizes that improving tolerability may allow patients to remain on effective therapy longer while preserving quality of life.
Transcript:
Dr. Halmos: I’m Balazs Halmos, medical oncologist from Montefiore Einstein Comprehensive Cancer Center from the Bronx, New York.
What did COPERNICUS show about subcutaneous amivantamab plus lazertinib and the practical experience of delivering targeted therapy?
Dr. Halmos: I was very lucky today to present results of COPERNICUS. Just to introduce this trial, this is coming in the backdrop of the MARIPOSA trial, which has brought IV amivantamab and lazertinib as a new standard of care for frontline management of patients with advanced EGFR-mutated lung cancer.
Of course, the regimen is very effective, extending survival by a year, year-plus. At the same time, it’s also a regimen with a fair number of adverse events; 34% of patients on MARIPOSA had to stop amivantamab. And since that time, we’ve learned how to manage this regimen better, going from the IV to a sub-Q version of amivantamab, as well as a number of prophylactic measures, prophylactic antibiotics, topical management for dermo adverse events, and preventive anticoagulation for a high risk of thromboembolic phenomena.
So now the COPERNICUS trial brings all those elements together and looks at the real-world patient population from the United States in the current presentation as to, with these measures, how have we modified the regimen? Have we made it a safer, more tolerable, more easy-to-deliver regimen to, for example, a community oncologist facing a patient in real-world practice?
Does subcutaneous delivery change which patients can realistically receive this regimen, particularly outside major academic centers?
Dr. Halmos: So absolutely. The subcutaneous version we know, and it’s also FDA-approved. You know, it’s a safer delivery of emicizumab and just as effective or even possibly more effective than the IV version, eliminating the chances of infusion reactions, which of course are very fearful as an adverse event for the patient, for the nursing professional, and the physician alike.
So starting with the sub-Q administration, we have a much lesser chance of administration-related reactions. We’re seeing only a single patient in the COPERNICUS trial facing a significant ARR, you know, the way we say it. And on top of that, the introduction of the dermatological prophylactic measures as well as the DOACs, the preventive anticoagulation, markedly reduces the rate of severe rashes as well as the rate of thromboembolic events.
So from three different perspectives, safer because of reduction of reactions, safer because of improvement of rash, and safer in terms of preventing thromboembolic events. Now this is a regimen that’s just a lot more comfortable for clinicians to offer and for patients to be able to receive, maintaining a better quality of life, and being able to stay on medicines that can extend life expectancy.
Overall survival is a very important goal.
