KEY TAKEAWAYS
- The MARIPOSA phase 3 trial aimed to assess post-progression safety and discuss nurses’ role in AE education.
- The results showed Ami+Laz’s promise as 1L therapy for NSCLC, emphasizing AE management’s vital role in treatment adherence.
Due to limited therapy options and high mortality rates in advanced non-small cell lung cancer (NSCLC) with cEGFR mutations, exploring alternative treatments is essential. The MARIPOSA study compared amivantamab (Ami)+ lazertinib (Laz) to osimertinib (Osi). Adverse events (AEs) from cancer treatments can affect patient experience, leading to treatment discontinuation and poor outcomes, underscoring nurses’ and HCPs’ critical role in AE management.
Sarah Smith and the team conducted a study to assess safety post-progression on the MARIPOSA regimen and explore nurses’ roles in AE education and proactive management.
About 1074 patients were randomized, and outcomes were reported for the Ami+Laz (efficacy/safety, n=429/n=421) and Osi (efficacy/safety, n=429/n=428) arms. Post-progression outcomes were assessed, including time to discontinuation (TTD), time to subsequent therapy (TTST), and safety. Nursing implications were drawn from the authors’ clinical experience in the trial and beyond.
The results revealed that after a median follow-up of 22 months, 35% of patients progressed on the Ami+Laz arm compared to 47% on the Osi arm. Among patients continuing treatment post-progression (53% vs. 51%), those on Ami+Laz remained on treatment longer (23.6 vs. 15.9 weeks).
Both TTD and TTST were longer with Ami+Laz (26.2 months and not estimable [NE], respectively) versus Osi (23.0 and 24.1 months).
The most common AEs occurred within the first 4 months of Ami+Laz treatment, with late-onset being uncommon. Nurses played a crucial role throughout the patient journey by counseling patients and caregivers on therapy options, promoting a better treatment experience, discussing the risk of progression, and planning the next steps post-progression.
They also educated patients about the likelihood of experiencing AEs such as infusion-related reactions (IRRs) and common dermatological AEs associated with targeted EGFR inhibition (rash and paronychia) while helping manage/mitigate these AEs to support patients during therapy.
The study concluded that Ami+Laz treatment showed promising post-progression outcomes, making it a viable first-line option for advanced NSCLC with cEGFR mutations. Incorporating nursing and HCP perspectives on AE management can enhance adherence, which is crucial for maximizing survival chances and benefits from second-line treatment in case of progression.
The trial was sponsored by Janssen Research & Development, LLC.
Source: https://ons.confex.com/ons/2024/meetingapp.cgi/Paper/15611
Clinical Trial: https://clinicaltrials.gov/study/NCT04487080
Smith S, Spira AI, Nguyen D, et al. (2024). “Post-progression and safety outcomes with first-line (1L) amivantamab plus lazertinib versus osimertinib in patients with advanced non-small cell lung cancer (NSCLC) with common EGFR mutations: Implications for best management practices.” Presented at ONS 2024 (I39)
