Pulmonology & Critical Care
RCT
● RCT
Combination therapy shows longer survival than standard drug in Asian lung cancer patients
Lung cancer (Amsterdam, Netherlands)
Published April 1, 2026
Hayashi Hidetoshi, Cho Byoung Chul, Kim Yu Jung, Lee Se-Hoon, Danchaivijitr Pongwut, Alip Adlinda, X…
Researchers studied whether a combination of two drugs, amivantamab and lazertinib, works better than the standard single drug, osimertinib, for treating a specific type of advanced lung cancer. The study involved 629 Asian patients who had never received treatment for their EGFR-mutant non-small cell lung cancer. They were randomly assigned to receive either the combination therapy, osimertinib alone, or lazertinib alone, and were followed for a median of about 39 months.
The main finding was that patients who received the amivantamab-lazertinib combination lived longer, on average, than those who received osimertinib. The data showed a 26% lower risk of death for the combination group. After three years, 61% of patients on the combination were alive, compared to 53% on osimertinib. The safety of the combination was reported to be consistent with what was seen in the larger trial population, though specific side effect details were not provided in this analysis.
It is important to be careful with these results for a few reasons. This was a subset analysis, meaning it looked at a specific group of patients from a larger trial. The statistical significance was described as 'nominal,' which suggests the finding needs further confirmation. Also, the median survival time for the combination group was 'not reached,' and any projection of how much longer it might be is based on a statistical assumption, not a direct measurement.
For readers, this research suggests the amivantamab-lazertinib combination is a promising first-line treatment option for this specific patient group. However, it is not yet a definitive new standard. Patients should discuss all available treatment options, including potential benefits and side effects, with their oncologist to make the best personal decision.
View Original Abstract ↓
BACKGROUND: Approximately 60 % of lung cancer cases occur in Asia, indicating an epidemiological disparity and need for effective therapies. Amivantamab-lazertinib is approved for first-line EGFR-mutated advanced non-small cell lung cancer (NSCLC) in many countries. In the protocol-specified final overall survival (OS) analysis of MARIPOSA (NCT04487080), amivantamab-lazertinib showed a statistically significant and clinically meaningful improvement in OS versus osimertinib (HR, 0.75; P = 0.005) among all participants. We evaluated OS for amivantamab-lazertinib versus osimertinib in Asian participants.
PATIENTS AND METHODS: Participants with previously untreated EGFR-mutated, locally advanced/metastatic NSCLC were randomized 2:2:1 to receive amivantamab-lazertinib, osimertinib, or lazertinib (for evaluating contribution of components). Self-identified Asian race was a stratification factor. OS was a key secondary endpoint.
RESULTS: Of 1074 randomized participants, 629 self-identified as Asian (amivantamab-lazertinib:250; osimertinib:251; lazertinib:128). At a median follow-up of 38.7 months, amivantamab-lazertinib significantly prolonged OS versus osimertinib among Asian participants. Median OS was not reached (NR; 95 % CI, NR-NR) for amivantamab-lazertinib versus 38.4 months (95 % CI, 35.1-NR) for osimertinib (HR, 0.74; 95 % CI, 0.56-0.97; nominal P = 0.026). Assuming exponential distribution of OS in both arms, amivantamab-lazertinib is projected to prolong median OS among Asian participants by > 12 months versus osimertinib. At 36 months, 61 % and 53 % were alive in the amivantamab-lazertinib and osimertinib arms. Safety profile was consistent with the overall population.
CONCLUSIONS: Consistent with the overall population, amivantamab-lazertinib significantly improved OS versus osimertinib among Asian participants with previously untreated EGFR-mutated advanced NSCLC, making it the first regimen to improve survival among Asian patients.
