Impressions of MARIPOSA Overall Survival and Potential Impact in Current SoC
Panelists discuss how the significant overall survival (OS) benefit demonstrated by the new combination therapy (mivantamab-lazertinib) compared with standard monotherapy makes it a preferred treatment option for most patients despite a slightly increased toxicity and time commitment.
Video content above is prompted by the following:
MARIPOSA Trial Results for EGFRm NSCLC Treatment
OS Data for Amivantamab-Lazertinib vs Osimertinib
The MARIPOSA trial demonstrates a significant OS benefit for the amivantamab-lazertinib combination compared with osimertinib monotherapy:
- HR of 0.75, indicating a 25% reduction in mortality risk
- Approximately one year improvement in median OS
- The OS benefit appears definitive, with final OS data now available
Impact on First-Line Treatment Approach
- Based on the discussion, this combination therapy appears positioned to become a preferred first-line option for EGFRm non–small cell lung cancer (NSCLC). The panelists strongly suggest that osimertinib monotherapy should now be limited to select cases (older, frail patients).
- Despite requiring more office visits and having somewhat increased toxicity, the survival benefit is considered to outweigh these challenges.
- The panelists anticipate this data would warrant the highest-level recommendation in treatment guidelines (such as NCCN).
- While acknowledging there is another combination that may read out later in 2025, the available OS data for amivantamab-lazertinib provides good clarity for treatment decisions.
Conclusion
The consensus among the panelists is that OS is the paramount end point for most patients, particularly younger ones, and this combination therapy delivers meaningfully on this metric.
