Updated data from the MARIPOSA-2 trial, presented at the European Society for Medical Oncology (ESMO) Congress 2024, demonstrate a statistically significant and clinically meaningful improvement in overall survival (OS) for patients with EGFR-mutated non-small cell lung cancer (NSCLC) treated with amivantamab plus chemotherapy following progression on osimertinib. The findings suggest a potential shift in second-line treatment strategies for this patient population.
The MARIPOSA-2 trial evaluated the efficacy and safety of amivantamab, a bispecific antibody targeting EGFR and MET, in combination with platinum-based chemotherapy, compared to chemotherapy alone, in patients with EGFR-mutated NSCLC who had progressed on or after osimertinib. The study's primary endpoint was progression-free survival (PFS), with OS as a key secondary endpoint.
The second interim analysis of OS revealed a significant benefit favoring the amivantamab plus chemotherapy arm. While specific hazard ratios and median survival times were not detailed in the provided source, the presentation at ESMO highlighted the clinical relevance of the observed improvement. This suggests that the addition of amivantamab to chemotherapy provides a survival advantage compared to standard chemotherapy alone in this setting.
These results have important implications for the treatment of EGFR-mutated NSCLC. Osimertinib is a standard first-line therapy for patients with these mutations; however, resistance inevitably develops. The MARIPOSA-2 data support the use of amivantamab plus chemotherapy as a viable second-line option after osimertinib failure, offering patients a chance for improved survival outcomes. Further details from the ESMO presentation and subsequent publications will provide a more comprehensive understanding of the magnitude of benefit and the specific patient subgroups who may benefit most from this treatment approach.
