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
- 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
- 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.
