Subcutaneous Amivantamab Combo is a “Clear” New Standard in EGFR+ NSCLC

According to data from the phase 3 PALOMA-3 trial (NCT05388669), infusion-related reactions occurred in 13% of patients who received subcutaneous amivantamab (Rybrevant Faspro) plus lazertinib (Lazcluze) compared with 66% of those who received the intravenous regimen.¹ The phase 2 PALOMA-2 trial (NCT05498428), presented at the IASLC 2026 World Conference on Lung Cancer (WCLC), reported a similar infusion-related reaction rate of 16% with subcutaneous amivantamab.²

Misako Nagasaka, MD, PhD, an associate clinical professor in the Division of Hematology/Oncology at the University of California, Irvine (UCI), who presented the PALOMA-2 data at WCLC, spoke with CancerNetwork® about whether subcutaneous amivantamab plus lazertinib should now be considered a clear new standard of care rather than just an alternative to intravenous therapy.

Editor’s Note: Nagasaka declares that her personal opinions/thoughts are hers and not those of UCI Health, UC Regents, and any other related entities.

Transcript:

CancerNetwork: Is there anything that still needs to be shown from this study population before subcutaneous amivantamab/lazertinib is something you'd consider a clear new standard rather than just an alternative to intravenous therapy?

Nagasaka: I think it is a clear standard. I don’t see the advantages of [intravenous] amivantamab. It takes a longer time to give, it fills up the infusion chair time, and there’s also more infusion-related reactions, whereas with subcutaneous amivantamab, those rates were much lower: 13% with PALOMA-3 and 16% with this study, PALOMA-2. It’s a safer drug, better tolerated, and more convenient for patients, so I think a lot of us have already shifted toward the subcutaneous amivantamab formulation, and that is the way to go.

I’ve only had one of my colleagues tell me about a patient where, surprisingly, their payer—their insurance—somehow wanted the [intravenous] formulation and not the subcutaneous formulation, but with time, I’m hopeful that that is going to change.

References

1. Leighl NB, Akamatsu H, Lim SM, et al. Subcutaneous versus intravenous amivantamab, both in combination with lazertinib, in refractory EGFR-mutated non-small cell lung cancer: primary results from the phase III PALOMA-3 study. J Clin Oncol. 2024;42(30):3593-3605. doi:10.1200/JCO.24.01001
2. Nagasaka M, Dias JM, Tan J-L, et al. First-line subcutaneous amivantamab plus lazertinib in EGFR-mutated advanced NSCLC: updated results from the PALOMA-2 study. Presented at: 2026 World Conference on Lung Cancer; September 12-15, 2026; Seoul, South Korea. Abstract PT2.03.06.