Administration of Amivantamab/Lazertinib

One of the challenges with the MARIPOSA regimen is the administration of the bispecific antibody amivantamab, which is currently given intravenously. This method carries a risk of infusion-related reactions and requires extended chair time in clinics—an issue for both health care systems and patients. Weekly infusions and staff availability add to the burden. The Paloma studies introduced a promising alternative: a subcutaneous formulation of amivantamab. This version significantly reduces infusion time—from hours to minutes—and lowers the incidence and severity of infusion-related reactions. These findings suggest that, once approved, the subcutaneous option could greatly improve the patient experience and logistical efficiency in clinics.

In addition to streamlining administration, adverse effect management is crucial, particularly given the known toxicity profile of EGFR-targeting agents like amivantamab. Skin-related adverse effects such as rash, itching, and nail issues are common due to the drug's activity on wild-type EGFR. The Cocoon study addressed this by evaluating the impact of proactive skin care. The study showed that prophylactic use of skin lotions, antibiotics, and nail care products significantly reduced the incidence and severity of rashes. More importantly, it led to fewer dose interruptions and improved patient-reported quality of life—highlighting that effective supportive care can enhance treatment adherence and patient well-being.

The importance of these findings lies in their practical implications. Ensuring patients can tolerate and stay on therapy maximizes the clinical benefit of treatment. With supportive care protocols modeled after those used in chemotherapy—such as the routine use of antiemetics—oncology teams can better manage the adverse effects of EGFR-targeted therapies. Additionally, educating patients about potential adverse effects and involving them in management improves engagement and outcomes. Together, the findings from the Paloma and Cocoon studies represent meaningful progress in making advanced therapies both more tolerable and accessible.