# Amivantamab

Source: https://onco.cc/drugs/amivantamab/  
OnCo record `amivantamab` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A two-armed antibody that blocks EGFR and its escape partner MET, now first-line for EGFR-mutant lung cancer with lazertinib.

## Summary

Amivantamab is a low-fucose bispecific IgG1 antibody that binds EGFR and MET at once, with enhanced ADCC and trogocytosis. It is approved for EGFR exon 20 insertion NSCLC (2021, with chemotherapy 2024, PAPILLON), first-line common EGFR mutations with lazertinib (MARIPOSA, 2024; OS benefit shown 2025), and post-osimertinib with chemotherapy (MARIPOSA-2). In MARIPOSA the combination extended progression-free survival to 23.7 versus 16.6 months against osimertinib (HR 0.70) and improved overall survival (HR 0.75). The cost is rash, nail toxicity and venous thromboembolism needing prophylactic anticoagulation; a subcutaneous formulation (2025) reduces infusion reactions. Whether the extra benefit justifies the extra burden is still debated. For a newcomer: the first regimen to beat the standard EGFR pill, at the price of more side effects.

## Fields

- Kind: Treatment
- Status: approved
- Last checked: 2026-09-04
- Brand: Rybrevant
- Modality: Bispecific antibody (EGFR×MET)
- Mechanism: Low-fucose bispecific IgG1 blocking EGFR and MET with enhanced ADCC/trogocytosis.
- Approvals: US 2021: EGFR exon 20 insertion NSCLC; US 2024: First-line EGFR-mutant NSCLC with lazertinib; EU 2021: Exon 20; 1L with lazertinib Jan 2025; England (NICE) 2022: Locally advanced or metastatic non-small-cell lung cancer with an EGFR exon 20 insertion after platinum-based chemotherapy: not recommended; England (NICE) 2026: Untreated advanced EGFR mutation-positive non-small-cell lung cancer (exon 19 deletion or L858R), with lazertinib; England (NICE) 2026: Untreated advanced non-small-cell lung cancer with an activating EGFR exon 20 insertion, with carboplatin and pemetrexed
- Dosing: IV infusion (subcutaneous Rybrevant Faspro available); 1,050 mg (<80 kg) or 1,400 mg (≥80 kg) weekly for 5 weeks (split first dose over 2 days), then every 2 weeks; with lazertinib 240 mg daily
- Toxicity (grade 3+): Rash 26%; Nail toxicity 11%; Infusion-related reaction 6%; Musculoskeletal pain 2.1%; Oedema 2.6%; Stomatitis 2.4%; Venous thromboembolism 11%; Paraesthesia 1.7%

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Amivantamab
- FDA label (DailyMed): https://dailymed.nlm.nih.gov/dailymed/search.cfm?query=Amivantamab
- NICE TA850: amivantamab for EGFR exon 20 insertion mutation-positive advanced non-small-cell lung cancer after platinum-based chemotherapy (not recommended): https://www.nice.org.uk/guidance/ta850
- NICE TA1122: amivantamab with lazertinib for untreated EGFR mutation-positive advanced non-small-cell lung cancer: https://www.nice.org.uk/guidance/ta1122
- NICE TA1158: amivantamab with carboplatin and pemetrexed for untreated EGFR exon 20 insertion mutation-positive advanced non-small-cell lung cancer: https://www.nice.org.uk/guidance/ta1158

## Connected records

- biomarkers: [EGFR exon 19 deletion](https://onco.cc/biomarkers/egfr-exon-19-deletion/), [EGFR exon 20 insertion](https://onco.cc/biomarkers/egfr-exon-20-insertion/), [EGFR L858R](https://onco.cc/biomarkers/egfr-l858r/), [MET amplification (gene copy number)](https://onco.cc/biomarkers/met-amplification-readout/)
- cancers: [EGFR-mutated non-small-cell lung cancer](https://onco.cc/cancers/egfr-mutant-nsclc/), [Lung cancer (all types)](https://onco.cc/cancers/lung-cancer/), [MET exon 14 and MET-amplified non-small-cell lung cancer](https://onco.cc/cancers/met-altered-nsclc/), [Non-small-cell lung cancer](https://onco.cc/cancers/nsclc/)
- technologies: [Bispecific antibodies](https://onco.cc/technologies/bispecific-antibody/)
- targets: [EGFR](https://onco.cc/targets/egfr/), [MET](https://onco.cc/targets/met/)
- companies: [Johnson & Johnson](https://onco.cc/companies/johnson-johnson/)
- terms: [Cancer Drugs Fund (England)](https://onco.cc/terms/cancer-drugs-fund/), [EGFR exon 19 deletion & L858R](https://onco.cc/terms/egfr-exon19-l858r/), [EGFR exon 20 insertion](https://onco.cc/terms/egfr-exon20-insertion/), [Lung cancer drugs in England: what NICE has recommended](https://onco.cc/terms/lung-uk-drug-access/), [MET amplification (bypass resistance)](https://onco.cc/terms/met-amplification/)
- trials: [A Study of Amivantamab Alone or in Addition to Other Treatment Agents in Participants With Head and Neck Cancer](https://onco.cc/trials/nct06385080/), [A Study of Amivantamab and Capmatinib Combination Therapy in Unresectable Metastatic Non-small Cell Lung Cancer](https://onco.cc/trials/nct05488314/), [A Study of Amivantamab and FOLFIRI Versus Cetuximab/Bevacizumab and FOLFIRI in Participants With KRAS/NRAS and BRAF Wild-type Colorectal Cancer Who Have Previously Received Chemotherapy](https://onco.cc/trials/nct06750094/), [A Study of Amivantamab and Lazertinib in Combination With Platinum-Based Chemotherapy Compared With Platinum-Based Chemotherapy in Patients With Epidermal Growth Factor Receptor (EGFR)-Mutated Locally Advanced or Metastatic Non- Small Cell Lung Cancer After Osimertinib Failure](https://onco.cc/trials/nct04988295/), [A Study of Amivantamab and mFOLFOX6 or FOLFIRI Versus Cetuximab and mFOLFOX6 or FOLFIRI as First-line Treatment in Participants With KRAS/NRAS and BRAF Wild-type Unresectable or Metastatic Left-sided Colorectal Cancer](https://onco.cc/trials/nct06662786/), [A Study of Amivantamab and Olomorasib Combination Therapy in Participants With Metastatic Non-Small Cell Lung Cancer](https://onco.cc/trials/nct07227025/), [A Study of Amivantamab in Addition to Standard of Care Agents (SOC) Compared With SOC Alone in Participants With Recurrent/Metastatic Head and Neck Cancer](https://onco.cc/trials/nct07276399/), [A Study of Amivantamab in Combination With Lazertinib, or Amivantamab in Combination With Platinum-Based Chemotherapy, for Common Epidermal Growth Factor Receptor (EGFR)-Mutated Locally Advanced or Metastatic Non-Small Cell Lung Cancer (NSCLC)](https://onco.cc/trials/nct06667076/), [A Study of Amivantamab in Participants With Advanced or Metastatic Solid Tumors Including Epidermal Growth Factor Receptor (EGFR)-Mutated Non-Small Cell Lung Cancer](https://onco.cc/trials/nct05498428/), [A Study of Amivantamab Monotherapy and in Addition to Standard-of-Care Chemotherapy in Participants With Advanced or Metastatic Colorectal Cancer](https://onco.cc/trials/nct05379595/), [A Study of Combination Amivantamab and Carboplatin-Pemetrexed Therapy, Compared With Carboplatin-Pemetrexed, in Participants With Advanced or Metastatic Non-Small Cell Lung Cancer Characterized by Epidermal Growth Factor Receptor (EGFR) Exon 20 Insertions](https://onco.cc/trials/nct04538664/), [A Study of Combination Therapy With Amivantamab and Cetrelimab in Participants With Metastatic Non-small Cell Lung Cancer](https://onco.cc/trials/nct05908734/), [A Study of Neoadjuvant Amivantamab With Either Lazertinib or Chemotherapy in Participants With Resectable EGFR-Mutated NSCLC](https://onco.cc/trials/nct07586202/), [A Study to Investigate Safety and Efficacy of Osimertinib and Amivantamab in Participants With Non-small Cell Lung Cancer With Common Epidermal Growth](https://onco.cc/trials/nct05801029/), [CHRYSALIS](https://onco.cc/trials/chrysalis/), [Enhanced Dermatological Care to Reduce Rash and Paronychia in Epidermal Growth Factor Receptor (EGRF)-Mutated Non-Small Cell Lung Cancer (NSCLC) Treated First-line With Amivantamab Plus Lazertinib](https://onco.cc/trials/nct06120140/), [MARIPOSA](https://onco.cc/trials/mariposa/), [Pre-operative Targeted Treatments in Molecularly Selected Resectable Colorectal Cancer (UNICORN)](https://onco.cc/trials/nct05845450/), [Premedication to Reduce Amivantamab Associated Infusion Related Reactions](https://onco.cc/trials/nct05663866/)
- key papers: [MARIPOSA: amivantamab plus lazertinib versus osimertinib as first treatment for EGFR-mutated lung cancer](https://onco.cc/key-papers/paper-mariposa-nejm-2024/)
- drugs: [Guardant360 CDx](https://onco.cc/drugs/guardant360-cdx/), [Lazertinib](https://onco.cc/drugs/lazertinib/)
- pairings: [Amivantamab + lazertinib (first-line EGFR NSCLC)](https://onco.cc/pairings/amivantamab-plus-lazertinib/), [EGFR TKI → ADC on progression](https://onco.cc/pairings/tki-then-adc-lung/)
- people: [Byoung Chul Cho](https://onco.cc/people/cho-byoung-chul/), [Dae Ho Lee](https://onco.cc/people/lee-dae-ho/)
- bottlenecks: [Acquired resistance to every therapy](https://onco.cc/bottlenecks/b-resistance/)
- ideas: [Add a drug when the blood test turns, without stopping the one that works](https://onco.cc/ideas/idea-bio1-molecular-progression-add-on/), [Add the second drug on day one when the escape route is predictable](https://onco.cc/ideas/idea-bio1-upfront-bypass-combination/)
- institutions: [Shanghai Chest Hospital](https://onco.cc/institutions/shanghai-chest-hospital/)
- pathways: [Drug-tolerant persister cells](https://onco.cc/pathways/drug-tolerant-persisters/), [Non-small cell lung cancer (KEGG map)](https://onco.cc/pathways/nsclc-signalling/), [Receptor tyrosine kinase activation](https://onco.cc/pathways/rtk-activation/), [Resistance routes: how a blocked pathway comes back](https://onco.cc/pathways/resistance-routes-map/)
- roadmaps: [Targeted therapy roadmap: imatinib → designed for resistance → the undruggable drivers fall](https://onco.cc/roadmaps/targeted-therapy-roadmap/)

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JSON: https://onco.cc/api/v1/entities/amivantamab.json