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Management of infusion-related reactions (IRRs) in patients receiving amivantamab in the CHRYSALIS study.
Park, Keunchil; Sabari, Joshua K; Haura, Eric B; Shu, Catherine A; Spira, Alexander; Salgia, Ravi; Reckamp, Karen L; Sanborn, Rachel E; Govindan, Ramaswamy; Bauml, Joshua M; Curtin, Joshua C; Xie, John; Roshak, Amy; Lorenzini, Patricia; Millington, Dawn; Thayu, Meena; Knoblauch, Roland E; Cho, Byoung Chul.
Afiliación
  • Park K; Dept of Thoracic/Head and Neck Medical Oncology, UT M.D. Anderson Cancer Center, Texas.
  • Sabari JK; NYU School of Medicine, New York, NY, USA.
  • Haura EB; H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA.
  • Shu CA; Columbia University Medical Center, New York, NY, USA.
  • Spira A; Virginia Cancer Specialists Research Institute, US Oncology Research, Fairfax, VA, USA.
  • Salgia R; City of Hope, Duarte, CA, USA.
  • Reckamp KL; Cedars-Sinai Medical Center, Los Angeles, CA, USA.
  • Sanborn RE; Earle A. Chiles Research Institute, Providence Cancer Institute, Portland, OR, USA.
  • Govindan R; Washington University School of Medicine, St. Louis, MO, USA.
  • Bauml JM; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
  • Curtin JC; Janssen R&D, Spring House, PA, USA.
  • Xie J; Janssen R&D, Spring House, PA, USA.
  • Roshak A; Janssen R&D, Spring House, PA, USA.
  • Lorenzini P; Janssen R&D, Spring House, PA, USA.
  • Millington D; Janssen R&D, Spring House, PA, USA.
  • Thayu M; Janssen R&D, Spring House, PA, USA.
  • Knoblauch RE; Janssen R&D, Spring House, PA, USA.
  • Cho BC; Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: cbc1971@yuhs.ac.
Lung Cancer ; 178: 166-171, 2023 04.
Article en En | MEDLINE | ID: mdl-36868177
BACKGROUND: Amivantamab, a fully humanized EGFR-MET bispecific antibody, has antitumor activity in diverse EGFR- and MET-driven non-small cell lung cancer (NSCLC) and a safety profile consistent with associated on-target activities. Infusion-related reaction(s) (IRR[s]) are reported commonly with amivantamab. We review IRR and subsequent management in amivantamab-treated patients. METHODS: Patients treated with the approved dose of intravenous amivantamab (1050 mg, <80 kg; 1400 mg, ≥80 kg) in CHRYSALIS-an ongoing, phase 1 study in advanced EGFR-mutated NSCLC-were included in this analysis. IRR mitigations included split first dose (350 mg, day 1 [D1]; remainder, D2), reduced initial infusion rates with proactive infusion interruption, and steroid premedication before initial dose. For all doses, pre-infusion antihistamines and antipyretics were required. Steroids were optional after the initial dose. RESULTS: As of 3/30/2021, 380 patients received amivantamab. IRRs were reported in 256 (67%) patients. Signs/symptoms of IRR included chills, dyspnea, flushing, nausea, chest discomfort, and vomiting. Most of the 279 IRRs were grade 1 or 2; grade 3 and 4 IRR occurred in 7 and 1 patients, respectively. Most (90%) IRRs occurred on cycle 1, D1 (C1D1); median time-to-first-IRR onset during C1D1 was 60 min; and first-infusion IRRs did not compromise subsequent infusions. Per protocol, IRR was mitigated on C1D1 with holding of infusion (56% [214/380]), reinitiating at reduced rate (53% [202/380]), and aborting infusion (14% [53/380]). C1D2 infusions were completed in 85% (45/53) of patients who had C1D1 infusions aborted. Four patients (1% [4/380]) discontinued treatment due to IRR. In studies aimed at elucidating the underlying mechanism(s) of IRR, no pattern was observed between patients with versus without IRR. CONCLUSION: IRRs with amivantamab were predominantly low grade and limited to first infusion, and rarely occurred with subsequent dosing. Close monitoring for IRR with the initial amivantamab dose and early intervention at first IRR signs/symptoms should be part of routine amivantamab administration.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Anticuerpos Biespecíficos / Carcinoma de Pulmón de Células no Pequeñas / Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos / Enfermedades del Sistema Inmune / Neoplasias Pulmonares Tipo de estudio: Guideline Límite: Animals / Humans Idioma: En Revista: Lung Cancer Asunto de la revista: NEOPLASIAS Año: 2023 Tipo del documento: Article Pais de publicación: Irlanda

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Anticuerpos Biespecíficos / Carcinoma de Pulmón de Células no Pequeñas / Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos / Enfermedades del Sistema Inmune / Neoplasias Pulmonares Tipo de estudio: Guideline Límite: Animals / Humans Idioma: En Revista: Lung Cancer Asunto de la revista: NEOPLASIAS Año: 2023 Tipo del documento: Article Pais de publicación: Irlanda