Evaluating the Clinical Utility of Subcutaneous Amivantamab in the Treatment of EGFR-Mutant mNSCLC

EP: 1.The Evolution of EGFR-Mutated Advanced NSCLC Treatment: Present Considerations and Future Treatment Options

EP: 2.Has Combination Therapy Become the New Frontline Treatment Standard for EGFR-Mutant Metastatic NSCLC?

EP: 3.Decision Points to Consider When Choosing Treatment With Monotherapy or Combination Therapy for EGFR-Mutant mNSCLC

EP: 4.Evaluating Patient Preferences for the Treatment of EGFR-Mutant mNSCLC

EP: 5.Comparing the Combination Therapies for the Treatment of EGFR-Mutant mNSCLC

EP: 6.Considering Resistance Mechanisms When Choosing Therapy in the Frontline Setting

EP: 7.The Importance of Maintaining Quality of Life and Intervening Early When Adverse Events Occur in the Frontline Treatment Setting

EP: 8.Weighing the 1-Year Projected Overall Survival Benefit With MARIPOSA in the Frontline Treatment of EGFR-Mutant mNSCLC

EP: 9.Discussing the Time and Financial Toxicities Associated With Combination Therapies and Potential Mitigation Strategies

EP: 10.Discussing Potential Combination Therapy Medication-Associated Toxicities With Patients

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EP: 11.Evaluating the Clinical Utility of Subcutaneous Amivantamab in the Treatment of EGFR-Mutant mNSCLC

EP: 12.The Importance of Multidisciplinary Collaboration With Subspecialty Physicians in the Toxicity Management With Treatment

EP: 13.Exploring Second-Line Treatment Options Including Targeted Radiation and Surgery for the Management of EGFR-Mutant mNSCLC

EP: 14.Tissue vs Plasma Biopsy After First Disease Progression in EGFR-Mutant NSCLC

EP: 15.Deciding Between a Biomarker-Directed Approach and a Biomarker-Agnostic Approach for Second-Line Treatment of EGFR-Mutant NSCLC

EP: 16.Continuing the Targeted TKI in the Second Line for the Treatment of EGFR-Mutant NSCLC

EP: 17.When to Consider Retreatment With Chemotherapy After FLAURA2 for EGFR-Mutant NSCLC

EP: 18.Patient Case Presentation: A 45-Year-Old With Newly Diagnosed EGFR-Mutant mNSCLC and Liver Metastases

EP: 19.Patient Case Presentation: A 69-Year-Old With Newly Diagnosed EGFR-Mutant mNSCLC and Symptomatic Brain Metastases

This segment explores how subcutaneous amivantamab could transform clinical practice for EGFR-mutant metastatic non–small cell lung cancer (mNSCLC) treatment. The availability of subcutaneous formulation would significantly lower clinicians’ thresholds for using amivantamab plus lazertinib combinations, with data from the PALOMA study showing promising results. The subcutaneous approach addresses one of the most challenging aspects of amivantamab therapy—the difficult first-day and second-day infusions that are burdensome for patients, nurses, and supportive care staff. The decreased infusion-related reactions represent a major clinical advantage, as these reactions create substantial treatment challenges and patient distress during initial therapy administration.

The subcutaneous formulation offers important clinical benefits beyond convenience, including a decreased risk of venous thromboembolism (VTE). While this reduction may not eliminate the need for prophylactic anticoagulation entirely, it could lower the overall thrombotic risk associated with amivantamab therapy. However, dermatologic toxicities would persist with subcutaneous administration, meaning that prophylactic strategies like those evaluated in the COCOON trial would remain necessary for optimal patient management. The maintained efficacy with improved tolerability profile makes subcutaneous amivantamab an attractive option for appropriate combination therapy candidates.

From a practical health care delivery perspective, subcutaneous administration could be transformative for infusion center operations and patient counseling. The reduced infusion chair time and eliminated need for prolonged intravenous infusions would improve resource utilization and patient throughput. Perhaps most importantly, the subcutaneous approach fundamentally changes how clinicians present treatment options to patients. Instead of describing a regimen requiring 2 intravenous chemotherapy agents plus an oral medication, clinicians can offer “an injection plus a pill”—a significantly more appealing proposition for patients weighing treatment options. This simplified administration approach could influence patient decision-making and improve treatment acceptance rates, potentially making combination therapy more accessible to patients who might otherwise decline due to infusion-related concerns.