Overview of NSCLC and Dermatologic Management
Panelists discuss how patients with EGFR-mutated non–small cell lung cancer develop dermatologic adverse events with amivantamab treatment, presenting as papules, pustules, and paronychia that significantly impact quality of life.
EGFR-mutated non–small cell lung cancer (NSCLC) has seen significant advances with targeted therapies like osimertinib, but patients inevitably develop resistance. Amivantamab, an EGFR-MET bispecific antibody, addresses both on-target EGFR mutations and off-target resistance pathways, including MET amplification and histologic transformation. In the MARIPOSA study, amivantamab demonstrated superior efficacy over osimertinib, with overall survival rates at 42 months of 56% vs 44% respectively.
Dermatologic adverse events represent the most common adverse effects associated with EGFR-targeting monoclonal antibodies in EGFR-mutated NSCLC treatment. These skin toxicities manifest as papules, pustules, pruritus (itchiness), pain, and burning sensations, predominantly affecting the scalp, face, chest, and back. Paronychia, a particularly challenging nail-related complication, also occurs frequently. Clinical data shows dermatologic adverse events affect 37% to 68% of patients treated with amivantamab across pivotal trials.
Current clinical guidelines recommend both physician-directed and at-home management strategies for these dermatologic complications, yet many patients continue experiencing breakthrough symptoms despite standard care approaches. The early onset of these adverse events, typically occurring within the first 4 months of treatment, coupled with the lack of prophylactic measures in initial studies, highlighted the need for proactive management strategies to optimize patient outcomes and treatment adherence in this challenging patient population.
