CO125 Adjusted comparison of amivantamab in combination with carboplatin plus pemetrexed from the PAPILLON study versus US real-world frontline treatments in patients with advanced NSCLC harboring EGFR exon 20 insertions

This study utilized data collected between 2012 and 2023 from 2 US databases (COTA NSCLC VANTAGE, ConcertAI Patient360 NSCLC) to create a real-world cohort. Patients aged 18 years or older with locally advanced/metastatic NSCLC, without prior systemic treatment, with ECOG PS 0-1 (when available), and confirmed exon20ins were included. Progression free survival (PFS), time to next treatment (TTNT), and overall survival (OS) of ACP from PAPILLON trial were compared to the pooled real-world physician choice (RWPC), using inverse probability weighting of the average treatment effect in the treated (IPW-ATT) adjustment for potential confounders.

A total of 94 real-world patients were obtained. Median follow-up was 50.5 months; 59.6% were female, 54.3% were over 65 years, 36.2% reported a history of smoking, 26.6% had liver metastases, and 33.0% had brain metastases. 1L treatments included platinum-based chemotherapy + immunotherapy (35.1%), EGFR TKI alone (25.5%), platinum-based chemotherapies (16.0%), immunotherapy alone (6.4%), or others (17.0%). Based on IPW-ATT adjustment, ACP showed statistically significant improvement vs pooled RWPC with HRs (95% CI) of 0.37 (0.25, 0.55), 0.34 (0.22, 0.52), and 0.43 (0.26, 0.70) for PFS, TTNT, and OS, respectively.

Building on the findings from the PAPILLON trial, the superior efficacy demonstrated by ACP compared to RWPC in this study further supports its adoption as the new standard of care for 1L patients with advanced NSCLC harboring EGFR exon20ins mutations.