{"entity":{"id":"mariposa","kind":"trial","name":"MARIPOSA","aka":[],"tldr":"The first regimen to beat osimertinib in EGFR-mutant lung cancer, with a survival benefit exceeding a year.","summary":"MARIPOSA, trial NCT04487080 sponsored by Johnson & Johnson and published in the New England Journal of Medicine in 2024, produced the first regimen to beat osimertinib in first-line EGFR-mutant non-small-cell lung cancer, with a survival benefit exceeding a year. It randomised 1,074 patients to amivantamab plus lazertinib or osimertinib, met its primary progression-free survival endpoint by blinded review and showed an overall survival benefit in 2025, at the cost of venous thromboembolism needing prophylaxis and skin toxicity needing management. Whether the survival gain justifies the added toxicity for every patient is the open question.","status":"positive","asOf":"2026-09-04","links":[{"label":"ClinicalTrials.gov NCT04487080","url":"https://clinicaltrials.gov/study/NCT04487080"}],"tags":[],"related":[],"cancers":["nsclc","egfr-mutant-nsclc"],"sections":[],"technologies":["bispecific-antibody"],"targets":["egfr","met"],"drugs":["amivantamab"],"companies":["johnson-johnson"],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":["lee-dae-ho","cho-byoung-chul"],"bottlenecks":[],"keyPapers":["paper-flaura-nejm-2018","paper-mariposa-nejm-2024"],"journals":[],"dependsOn":[],"notes":[],"nct":"NCT04487080","phase":"3","setting":"First-line EGFR-mutant NSCLC: amivantamab + lazertinib vs osimertinib","sponsor":"Johnson & Johnson","result":"PFS HR 0.70; OS HR 0.75.","started":"2020-09-30","startedType":"actual","yearReported":2023,"enrolled":1074,"enrolledBasis":"registry","outcomes":[{"endpoint":"Progression-free survival (BICR)","primary":true,"unit":"months","arms":[{"name":"Amivantamab + lazertinib","n":429,"value":23.7},{"name":"Osimertinib","n":429,"value":16.6}],"hr":0.7,"ci":[0.58,0.85],"p":"<0.001","source":"https://www.nejm.org/doi/full/10.1056/NEJMoa2403614"},{"endpoint":"Overall survival","unit":"months","arms":[{"name":"Amivantamab + lazertinib","note":"Median not reached"},{"name":"Osimertinib","value":36.7}],"hr":0.75,"ci":[0.61,0.92],"p":"0.005","source":"https://clinicaltrials.gov/study/NCT04487080"}],"replication":"Single pivotal trial versus osimertinib; MARIPOSA-2 (post-osimertinib) and PALOMA-3 (subcutaneous) support the regimen in adjacent settings."},"route":"/trials/mariposa/","neighbours":{"cancer":[{"id":"egfr-mutant-nsclc","kind":"cancer","name":"EGFR-mutated non-small-cell lung cancer","route":"/cancers/egfr-mutant-nsclc/"},{"id":"lung-cancer","kind":"cancer","name":"Lung cancer (all types)","route":"/cancers/lung-cancer/"},{"id":"nsclc","kind":"cancer","name":"Non-small-cell lung cancer","route":"/cancers/nsclc/"}],"technology":[{"id":"bispecific-antibody","kind":"technology","name":"Bispecific antibodies","route":"/technologies/bispecific-antibody/"}],"target":[{"id":"egfr","kind":"target","name":"EGFR","route":"/targets/egfr/"},{"id":"met","kind":"target","name":"MET","route":"/targets/met/"}],"drug":[{"id":"amivantamab","kind":"drug","name":"Amivantamab","route":"/drugs/amivantamab/"},{"id":"lazertinib","kind":"drug","name":"Lazertinib","route":"/drugs/lazertinib/"}],"company":[{"id":"johnson-johnson","kind":"company","name":"Johnson & Johnson","route":"/companies/johnson-johnson/"}],"person":[{"id":"cho-byoung-chul","kind":"person","name":"Byoung Chul Cho","route":"/people/cho-byoung-chul/"},{"id":"lee-dae-ho","kind":"person","name":"Dae Ho Lee","route":"/people/lee-dae-ho/"}],"paper":[{"id":"paper-flaura-nejm-2018","kind":"paper","name":"FLAURA: osimertinib as first treatment for EGFR-mutated lung cancer","route":"/key-papers/paper-flaura-nejm-2018/"},{"id":"paper-mariposa-nejm-2024","kind":"paper","name":"MARIPOSA: amivantamab plus lazertinib versus osimertinib as first treatment for EGFR-mutated lung cancer","route":"/key-papers/paper-mariposa-nejm-2024/"}],"pairing":[{"id":"amivantamab-plus-lazertinib","kind":"pairing","name":"Amivantamab + lazertinib (first-line EGFR NSCLC)","route":"/pairings/amivantamab-plus-lazertinib/"},{"id":"targeted-before-io-nsclc","kind":"pairing","name":"Sequence: targeted therapy before immunotherapy in driver-positive NSCLC","route":"/pairings/targeted-before-io-nsclc/"}],"bottleneck":[{"id":"b-resistance","kind":"bottleneck","name":"Acquired resistance to every therapy","route":"/bottlenecks/b-resistance/"}],"idea":[{"id":"idea-bio1-upfront-bypass-combination","kind":"idea","name":"Add the second drug on day one when the escape route is predictable","route":"/ideas/idea-bio1-upfront-bypass-combination/"}],"roadmap":[{"id":"targeted-therapy-roadmap","kind":"roadmap","name":"Targeted therapy roadmap: imatinib → designed for resistance → the undruggable drivers fall","route":"/roadmaps/targeted-therapy-roadmap/"}]}}