MARIPOSA Social Conversations Amid Promising New OS Data for Patients with EGFR-mutated NSCLC

In a groundbreaking development for lung cancer treatment, Johnson & Johnson announced on January 7, 2025, that the combination of RYBREVANT® (amivantamab-vmjw) and LAZCLUZE™ (lazertinib) demonstrated a significant improvement in overall survival compared to the current standard of care in patients with EGFR-mutated non-small cell lung cancer (NSCLC).

Breaking Down the MARIPOSA Study

The Phase 3 MARIPOSA study, which enrolled 1,074 patients, has been closely watched by the oncology community since its initial progression-free survival (PFS) results were reported. The latest data reveals that the combination therapy is expected to extend median overall survival by more than one year compared to osimertinib alone, marking a historic milestone in the treatment of EGFR-mutated NSCLC.

Dr. Stephen Liu, Director of Thoracic Oncology at Georgetown's Lombardi Comprehensive Cancer Center, emphasized the significance of this finding: "Seeing this increase in overall survival in a trial with mature data is powerful and reaffirms that first-line treatment with RYBREVANT and LAZCLUZE can lead to better patient outcomes."

Expert Reactions and Analysis

The oncology community has been actively discussing these results on social media, with several key opinion leaders sharing their insights:

Dr. Luis Raez from Memorial Cancer Institute shared the importance the Survival Data versus the current standard of care, Tagrisso. He also discussed clinical options for improving tolerability of the "Ami+Laz" combination.

Patient Advocate Jill Feldman further emphasized her support for the new "AmiI+Laz" combination, claiming, "This is what patients want and need!"

Jill Feldman further broke down the implications of the results for patients with a detailed tweet summarizing her thoughts on the newly released MARIPOSA data. She stressed the importance of 1 year of survival for patients, and the ability to manage adverse events from the therapy. She also highlighted the importance of subset analysis in future data updates.

Dr. Amol Akhade shared a helpful poll from his peers, where the support for the Ami-Laz therapy was about 40% based on poll results as compared to Osimertinib(Tagrisso) based therapies.

Dr. Akhade engaged in an interesting discussion regarding the MARIPOSA data with Dr. Ambika, a community oncologist from Nevada. It seems that the single agent Osimertinib (TAGRISSO) use in this setting will be for a much smaller set of patients going forward, "frail pts with low tumor burden", based on the tweet discussion.

Clinical Implications

The significance of these results cannot be overstated, particularly given the current survival statistics for EGFR-mutated NSCLC. As noted in the study background, less than 20% of patients with advanced NSCLC and EGFR mutations treated with EGFR tyrosine kinase inhibitors survive five years.

The RYBREVANT and LAZCLUZE (Ami+Laz) combination has generated significant discussion by NSCLC experts regarding the clinical setting.

Dr. Passaro, a lung cancer expert from Italy, claimed that the new Ami+Laz combo is the "new standard of care". He further emphasized the Overall survival benefit and and management of Adverse Events in his discussion.

Management of toxicities with the new combo of Ami-Laz may be the most important factor for oncologists treating patients for first line stage 4 EGFRmut NSCLC. 

Below is a discussion just after ASCO24 by Dr. Tom Newsom-Davis from the UK discussing treatment challenges with Amivantanab.

However, Dr. Estela Rodriguez from University of Miami, Sylvester Cancer Center, claimed that the OS benefit of the MARIPOSA trial trumps the toxicity of the combo "in most cases".

Safety Considerations

While the efficacy data is promising, the oncology community has noted important safety considerations. The combination therapy requires careful management of side effects, including:

• Infusion-related reactions
• Skin reactions
• Risk of blood clots (particularly in the first four months of treatment)

The subcutaneous regimen of Ami+ Laz may be a future option to reduce the infustion-related reactions,  pending an FDA hold based on manufacturing concerns. 

With regards to management of skin toxicities, Key Opinion Leaders have expressed their excitement over the results of the COCOON Phase 2 clinical trial.

Looking Ahead

Key Opinion Leaders are excited to have multiple therapies to offer their patients in the 1st Line advanced EGFRmut NSCLC setting. Many are encouraged about the release of these survival results by Johnson & Johnson, while some others like Dr. Pennell are eager to dig into the data during the presentation and publication of these newly released results.

Here's a helpful video clip of the MARIPOSA trial discussion from ASCO24 by Dr. Sabari with the Oncology Brothers.

Social Discussion Visualization

Click image to view the fully interactive social diagram and other valuable content surrounding MARIPOSA KOL opinions.