Subcutaneous versus intravenous amivantamab, both in combination with lazertinib, in refractory EGFR-mutated non-small cell lung cancer: Patient satisfaction and resource utilization results from the PALOMA-3 study

Introduction: Intravenous anticancer treatments present challenges for patients and healthcare professionals (HCPs), prompting the development of subcutaneous formulations. In the phase 3 PALOMA-3 study, subcutaneous amivantamab demonstrated noninferior pharmacokinetics and response rates versus intravenous amivantamab (both with lazertinib), with substantially faster administration, a 5-fold reduction in infusion-related reactions, reduced venous thromboembolism, and numerically prolonged survival. Methods: Participants with EGFR-mutated NSCLC and progression on osimertinib and chemotherapy were randomized to subcutaneous (n = 206) or intravenous amivantamab (n = 212), plus lazertinib. Resource utilization and participant-reported treatment satisfaction were evaluated at cycle (C) 1 day (D) 1 and C3D1. Results: Time-in-chair was substantially lower for subcutaneous versus intravenous amivantamab (C1D1: median [range], 23 min or 0.4 h [0–12.0 h] vs 6.5 h [0–24.0 h]; C3D1: 35 min or 0.6 h [0–6.6 h] vs 3.4 h [0.5–9.0 h]), as were HCP time and participant time-in-room. More participants who received subcutaneous versus intravenous amivantamab reported feeling unrestricted (C1D1, 66 % vs 29 %; C3D1, 60 % vs 42 %) or unbothered (C1D1, 69 % vs 30 %; C3D1, 71 % vs 45 %) by administration, and reported gaining time for other activities (C1D1, 36 % vs 7 %; C3D1, 37 % vs 6 %). Few participants who received subcutaneous amivantamab reported moderate-to-very severe injection-site pain (C1D1, 14 %; C3D1, 16 %), swelling (C1D1, 5 %; C3D1, 6 %), or redness (C1D1, 5 %; C3D1, 6 %). Most subcutaneous amivantamab recipients preferred and were more satisfied with its administration versus historical experience with intravenous therapies and would recommend it. Conclusions: In PALOMA-3, subcutaneous amivantamab, which simplifies and shortens administration, reduces resource utilization, and enhances treatment experience, was a preferred option for patients who received amivantamab-lazertinib.