Abstract
Targeted therapies have transformed outcomes of patients with advanced non-small cell lung cancer. Amivantamab, a bispecific antibody targeting epidermal growth factor receptor (EGFR) and MET, and lazertinib, a third-generation EGFR tyrosine kinase inhibitor, were approved in 2024 for the first-line treatment of EGFR-mutated (exon 19 deletion/exon 21 L858R substitution) locally advanced or metastatic non-small cell lung cancer. While EGFR-targeted therapies have demonstrated clinical efficacy, they are associated with on-target dermatologic adverse events (AEs). This vodcast aims to educate on strategies to mitigate and manage dermatologic AEs associated with amivantamab + lazertinib. The MARIPOSA study assessed amivantamab + lazertinib versus osimertinib in previously untreated patients with EGFR-mutated locally advanced or metastatic non-small cell lung cancer. In the same population, the COCOON study assessed the impact of enhanced versus standard dermatologic management on the incidence of grade ≥ 2 dermatologic AEs. In MARIPOSA, amivantamab + lazertinib significantly improved overall survival (median not reached vs 36.7 months) and progression-free survival (median 23.7 vs 16.6 months) versus osimertinib. The most common EGFR-associated dermatologic AEs were rash and paronychia. To address these AEs, the COCOON study evaluated enhanced dermatologic management strategies (including prophylactic oral and topical antibiotics and moisturizer) versus standard of care dermatologic management, which resulted in a two-fold reduction in grade ≥ 2 dermatologic AEs with COCOON versus standard dermatologic management. We further discuss the COCOON prophylactic regimen together with reactive and expert-recommended dermatologic management approaches. In conclusion, amivantamab + lazertinib is an effective treatment that significantly improves overall survival. While dermatologic AEs are common, effective proactive management strategies, as demonstrated in the COCOON study, can help reduce the incidence and severity of dermatologic AEs. Prioritizing education for healthcare providers and patients will facilitate timely identification and proactive and reactive management of these events, ultimately improving the treatment experience for patients undergoing therapy with amivantamab and lazertinib.
Supplementary Information
The online version contains supplementary material available at 10.1007/s11523-025-01163-3.
Key Points
| Dermatologic adverse events are common with epidermal growth factor receptor (EGFR)-targeted therapies, including amivantamab + lazertinib, which was recently approved for the first-line treatment of EGFR-mutated non-small cell lung cancer. |
| Dermatologic adverse events can impact patients’ quality of life; this vodcast provides up-to-date proactive and reactive management strategies for dermatologic adverse events based on studies of amivantamab + lazertinib. |
The vodcast and transcript can be viewed below the abstract of the online version of the article. The slide deck is included as an Electronic Supplementary File with the online version of the article. Alternatively, the vodcast and slide deck can be downloaded here: 10.6084/m9.figshare.29318654.
Supplementary file1 (MP4 408454 KB)
Transcript
Introduction
Dr. Nguyen:
Welcome to our vodcast entitled Dermatologic Adverse Event Mitigation and Management Strategies with Amivantamab + Lazertinib Therapy for Patients with EGFR-Mutated Non-Small Cell Lung Cancer. My name is Danny Nguyen and I’m an oncologist and Assistant Professor at City of Hope in California. I’m joined by my colleague Dr. Edgardo Santos.
Dr. Santos:
Thank you, Dr. Nguyen, for the introduction. Once again, my name is Edgardo Santos from the Oncology Institute of Hope and Innovation. I’m an Associate Professor of Medicine at Florida Atlantic University in Boca Raton, Florida.
Dr. Nguyen:
The intent of this vodcast is to briefly review the efficacy data with amivantamab + lazertinib from the MARIPOSA study, including updated overall survival. We will also review the types, incidence, and severity of EGFR-related dermatologic side effects associated with amivantamab + lazertinib. We will then discuss the reactive and prophylactic management strategies for these dermatologic adverse events, highlighting new data using prophylactic strategies based on the COCOON study.
MARIPOSA Overview
Now for a bit of background information, epidermal growth factor receptor, or EGFR, is involved in cell signaling pathways that control cell division and survival [1]. It’s widely expressed in normal tissues, including epithelial tissue, skin, and hair follicles, and promotes wound healing and maintains skin homeostasis. That is why inhibition of EGFR can result in cutaneous toxicities, otherwise known as on-target effects [1–8].
EGFR mutations are the most common mutations in non-small cell lung cancer, most commonly exon 19 deletion and exon 21 L858R point mutations [2–5]. The frequency of EGFR mutations in patients with non-small cell lung cancer varies by ethnicity, with the highest frequencies seen in Asian populations [6].
Amivantamab is a fully human bispecific antibody that has three proposed mechanisms of action. First, it targets EGFR and MET extracellularly, thereby blocking ligand binding. MET is oftentimes overexpressed as a resistance mechanism to current EGFR-targeted therapies. Second, it promotes receptor degradation. And third, it harnesses the immune system to promote cell death [9–12]. Lazertinib on the other hand, is a CNS-penetrant third-generation tyrosine kinase inhibitor, or TKI, that targets the EGFR receptor intracellularly and also has activity against the T790M resistance mutation [10].
This combination of amivantamab + lazertinib works synergistically, is more potent than any of the therapy alone, and can overcome various resistance mechanisms [12]. Amivantamab + lazertinib was approved as first-line treatment for patients with EGFR-mutated advanced or metastatic non-small cell lung cancer in August 2024 by the FDA [13], and in January 2025 by the European Commission [14] based on results of the MARIPOSA study, which we will now review.
MARIPOSA is a randomized phase III study evaluating the efficacy of amivantamab and lazertinib versus osimertinib as first-line treatment for patients with EGFR-mutated advanced non-small cell lung cancer [12]. A total of 1074 patients were randomized in a 2:2:1 ratio to receive amivantamab + lazertinib, osimertinib, or lazertinib alone. The lazertinib-alone arm was non-registrational and was included to study the contribution of lazertinib to the overall treatment regimen [15, 16]. The primary endpoint was progression-free survival, and the key secondary endpoint was overall survival.
At the final prespecified analysis, amivantamab + lazertinib significantly improved overall survival by 25%, with a median OS not yet reached versus 36.7 months with osimertinib. Sixty percent of patients were alive at 3 years in the amivantamab + lazertinib arm versus 51% for patients in the osimertinib arm; benefit continued at 42 months, with survival rates of 56% and 44%, respectively. In addition, amivantamab + lazertinib also significantly improved progression-free survival by 30%, with a median PFS of 23.7 months versus 16.6 months with osimertinib [12].
Now, let’s talk about the safety profile of amivantamab and lazertinib. The slide here shows any grade and grade 3 or higher adverse events associated with amivantamab and lazertinib from the MARIPOSA study. Most adverse events were grade 1 or 2 and the most common were paronychia, rash, and infusion-related reactions, each occurring in more than half of patients. The most common laboratory abnormalities were low albumin and elevated AST and ALT. In terms of onset, new adverse events, including skin reactions, typically occurred during the first 4 months of therapy. As you can see here, new onset adverse events generally decreased over time.
Mitigation and Management of Dermatologic Adverse Events
We know that dermatologic adverse events can impact patient quality of life and therefore, treatment adherence. Now, we’ll move on to strategies to help prevent and manage these skin toxicities with amivantamab + lazertinib.
Skin toxicities are ongoing events, and this slide here shows the dose modification recommendations based on the amivantamab label. Supportive care, such as antihistamines, topical steroids, antibiotics, and treatment holidays are also recommended to manage skin adverse events based on the amivantamab and lazertinib prescribing labels and the MARIPOSA protocol [15–17]. Newer ongoing studies, such as the COPERNICUS study, are assessing additional supportive strategies such as zinc supplementation.
Rash was a common dermatologic adverse event in MARIPOSA, affecting 86% of patients, with grade 3 rash occurring in 26% of patients [15]. The median time to onset was 14 days, and rash led to dose interruptions in 37%, reductions in 23%, and discontinuations in 5% of patients [15]. Rash can be characterized as papules, pustules, itchiness, pain, and bleeding [17], and sometimes rash can be more difficult to monitor in patients with darker skin tones, potentially leading to delayed detection and treatment in these patients, and therefore, increased risk of permanent sequelae [18].
Dr. Santos, can you share your experience with managing rash events associated with amivantamab and lazertinib treatment?
Dr. Santos:
Per amivantamab and lazertinib prescribing information, it is recommended to prophylactically initiate use of alcohol-free (e.g., isopropanol-free, ethanol-free) emollient creams (e.g., glycerin, cetomacrogol, or ceramide based per the MARIPOSA protocol) [12, 15, 16]. In addition, lifestyle measures are advised, including limiting sun exposure during and for 2 months after treatment, wearing broad-spectrum sunscreen (≥ 30 SPF), protective clothing and hats, avoiding steroid use on open wounds, and avoiding frequent washing/hot water [12, 15, 16].
Prophylactic topical and oral antibiotics are also recommended [15, 16]. Note that only a minority (21%) of patients were prescribed antibiotics for rash at study initiation in MARIPOSA. Per MARIPOSA protocol, strongly consider initiating antibiotics on cycle 1 day 1 and continuing antibiotic therapy for the first 8 weeks: both a topical antibiotic (clindamycin, mupirocin, or fusidic acid) on sun-exposed skin, and an oral antibiotic (e.g., doxycycline 100 mg once daily, minocycline 100 mg once daily, or cephalexin 500 mg once daily) [12]. A topical corticosteroid of medium-to-low potency twice daily on the face and chest (e.g., alclometasone 0.05% or desonide 0.05% cream) may also be considered [12].
Per amivantamab and lazertinib prescribing information, if a patient experiences grade 1 or 2 rash, it is recommended to treat with topical corticosteroids [15, 16]. For example, betamethasone valerate 0.05%, hydrocortisone valerate 0.2%, or desonide 0.05% for the face [12] and betamethasone valerate 0.1% or triamcinolone acetonide 0.1% for the body. Treatment with systemic antibiotics can also be considered (e.g., doxycycline 100 mg twice daily, minocycline 100 mg twice daily), or dosing increased if already administered. Treatment for at least 6 weeks is recommended [12]. No dosing modifications are necessary; however, the patient should be reassessed in 2 weeks [12].
For grade 3 or 4 adverse events, consult with a dermatologist and consider addition of systemic steroids (prednisone 0.5 mg/kg for 7 days), with low doses of acitretin or isotretinoin (20–30 mg/day); amivantamab + lazertinib treatment should be temporarily withheld until the rash improves to grade 2 or lower [15, 16]. If patients present with a severe rash, atypical appearance or distribution, or there is lack of improvement within 2 weeks (for grade 2 rash per the MARIPOSA protocol), promptly refer patients to a dermatologist and withhold, reduce the dose, or discontinue amivantamab and lazertinib [12, 15, 16].
An additional skin-related adverse event observed in the MARIPOSA trial was scalp rash, which may present as an acneiform rash consisting of erupted papules and pustules on the scalp [17]. As indicated in the MARIPOSA protocol, lifestyle recommendations to prevent scalp rash include avoiding direct exposure to sun [12]. If scalp rash occurs, it may be managed with a topical steroid shampoo (e.g., clobetasol) or an anti-dandruff shampoo with anti-inflammatory, antibacterial, and antifungal properties (e.g., ketoconazole, selenium sulfide [Selsun], zinc pyrithione [Head and Shoulders], or Ciclopirox) twice weekly [12]. Steroid lotions may also be effective (e.g., betamethasone valerate 0.1% lotion, mometasone furoate 0.1% lotion, or betamethasone dipropionate 0.05% lotion) [12]. For acute scalp infections, systemic antibiotics (e.g., doxycycline 100 mg twice daily, minocycline 100 mg twice daily) may be used [12].
Pruritus is another dermatologic adverse event that was reported in the MARIPOSA study and is often reported with papulopustular or acneiform rash and dry skin [19–21]. Pruritus was mostly grade 1 or 2 in MARIPOSA.
Pruritus can be prophylactically managed by frequent use of moisturizers and only using detergents and soaps that are fragrance free. Currently, there is no standard treatment for EGFR TKI-induced pruritus [22]. The MARIPOSA protocol provides management strategies based on severity: for cases that are grade 1, a low-to-moderate strength topical steroid cream, topical calcineurin inhibitor, or topical antipruritic-containing numbing agent and menthol can be used [12]. For grade 2, the strength of the steroid cream can be increased to a moderate or high strength. A topical antipruritic-containing numbing agent such as pramoxine and menthol can also be helpful for grade 2 events. An oral antipruritic agent may be initiated [12]. For severe cases, an oral antipruritic agent is recommended along with an oral GABA agonist such as pregabalin or gabapentin. Oral corticosteroids such as prednisone can also be initiated for 5 days [12].
Dr. Nguyen:
Thank you Dr. Santos for that information. Another skin-related adverse event observed in MARIPOSA was paronychia, which presents as pain, erythema, and swelling of the lateral nail folds, which progress into formation of friable granulation tissue at the nail folds, sometimes mimicking ingrown nails. The thumbs and great toes are typically affected, but any of the digits can be affected, and sometimes multiple at one time [17].
Dr. Santos, can you speak to recommendations regarding the management of paronychia?
Dr. Santos:
There are no approved treatments for paronychia, and recommendations are mainly based on expert opinion. Management strategies are aimed at minimizing periungual trauma, decreasing periungual inflammation, preventing superinfection, and eliminating excessive granulation tissue [17]. As indicated in the MARIPOSA protocol, paronychia may be prophylactically managed by avoiding skin irritants, wearing gloves and comfortable shoes, cushioning affected areas, and applying moisturizer to nails [12].
For patients who experience grade 1 paronychia, antimicrobial soaks once or twice daily (which includes a warm bowl of water + 5 mL of bleach [sodium hypochlorite] or vinegar [DO NOT USE BOTH TOGETHER]) are recommended [12]. Other recommendations include the use of a topical antiseptic (povidone-iodine 10% solution twice daily) and topical steroids (e.g., betamethasone valerate 0.1% or clobetasol) or a topical calcineurin inhibitor (e.g., tacrolimus 0.1% twice daily) [12]. If using a topical steroid, once resolved, switch to a topical calcineurin inhibitor daily, or for maintenance, decrease to biweekly use [12].
For grade 2 or 3 paronychia, consider addition of topical antibiotics or antifungals (e.g., mupirocin, fusidic acid, clotrimazole, or miconazole twice daily) and oral antibiotics (e.g., doxycycline 100 mg twice daily, minocycline 100 mg twice daily, or cephalexin 500 mg twice daily) for at least 14 days. Consult a dermatologist or podiatrist [12].
To summarize what we have covered so far, management of dermatologic adverse events associated with amivantamab + lazertinib is shown here in consolidated tables that can be used by medical oncologists and dermatologists to help determine appropriate treatment based on severity. One consideration is that these guidelines should be followed irrespective of amivantamab formulation; in other words, dermatologic adverse events can occur with either intravenous or subcutaneous amivantamab as seen in the PALOMA studies [23]. Subcutaneous amivantamab is awaiting Food and Drug Administration approval.
COCOON: Evaluating Prophylactic Management of Dermatologic Adverse Events
Dr. Nguyen:
Thank you for that Dr. Santos, very helpful for our patients and caregivers. The management strategies we have presented here so far were based on the MARIPOSA study and amivantamab + lazertinib prescribing information. Because we know that dermatologic adverse events can have a major impact on patient quality of life and treatment adherence, it was felt that additional prophylactic measures could help prevent some of the dermatologic adverse events seen with amivantamab + lazertinib.
COCOON is a prospective, phase II, randomized study evaluating the impact of an enhanced prophylactic skincare regimen versus standard of care regimen on the incidence of dermatologic adverse events in patients being treated with amivantamab + lazertinib, the same population used in the MARIPOSA study [24, 25]. The primary endpoint of COCOON is the incidence of grade 2 or greater dermatologic adverse events of interest in the first 12 weeks after treatment initiation. Key secondary endpoints include the number of grade 2 or greater dermatologic adverse events per patient, incidence and severity of paronychia and scalp rash, and the frequency of dose reductions and interruptions and discontinuations due to adverse events.
The enhanced prophylactic skincare regimen is shown here on the slide that was used in the COCOON study. This includes prophylactic antibiotics such as doxycycline and minocycline at 100 mg BID for the first 3 months. That is followed by topical clindamycin lotion, 1% on the scalp daily before bedtime, up to 12 months. Patients are then also given a chlorhexidine, 4% solution applied to the fingernails and toenails once daily from the start of treatment, and a ceramide-based moisturizer applied to the face and body at least once a day [24, 25]. The standard of care dermatologic management regimen includes general skin care prophylaxis, as well as whatever is used by the local practice, and reactive management, such as topical corticosteroids and systemic antibiotics [24, 25].
At the first interim analysis, with 70% of patients completing the first 12-week assessment, the COCOON study met its primary endpoint [24, 25]. In the first 12 weeks, there was a statistically significant two-fold reduction in grade 2 or greater dermatologic adverse events from 76.5 to 38.6% and grade 3 dermatologic adverse events from 8.8 to 4.3% with the COCOON regimen versus standard of care management [24, 25]. When looking at the incidence at specific body locations, the COCOON regimen resulted in an approximately 65% reduction in facial or body dermatologic adverse events, a 70% reduction in scalp rash, and a 25% reduction in paronychia [24, 25].
Together, these results demonstrate that the prophylactic regimen used in the COCOON study significantly reduces the incidence and severity of skin adverse events associated with amivantamab and lazertinib treatment. The COCOON study is now fully enrolled with additional results planned at upcoming meetings.
To summarize, the prophylactic COCOON regimen is shown again here. The study demonstrated that prophylactic strategies are important and can make a huge difference in preventing or limiting the severity of dermatologic adverse events with amivantamab + lazertinib. Just note that these strategies apply to both the IV and subcutaneous formulations of amivantamab as well.
Concluding Remarks
To conclude our vodcast, amivantamab + lazertinib showed statistically significant improvement in overall survival and progression-free survival in the MARIPOSA study in patients with EGFR-mutated advanced non-small cell lung cancer. The prophylactic COCOON regimen significantly reduced the incidence and severity of dermatologic adverse events with amivantamab + lazertinib.
Altogether, the recommendations provided here from the amivantamab prescribing label, the MARIPOSA protocol, and the COCOON study can hopefully increase provider understanding and confidence in proactively and reactively managing these dermatologic adverse events with this regimen.
We hope that these strategies will improve patient outcomes and adherence to therapy and ultimately improve patient experience and quality of life. Thank you.
Dr. Santos:
Thank you Dr. Nguyen. It was a pleasure to share this vodcast with you. I would like to see that this vodcast helps our healthcare professionals in the community, in academic practice, to manage these dermatologic side effects that our patients may face if they are treated with this regimen. Thank you once again.
Supplementary Information
Below is the link to the electronic supplementary material.
Declarations
Funding
This study was funded by Johnson & Johnson.
Conflicts of Interest/Competing Interests
Danny Nguyen reports: honoraria/advisory role: Novartis and Takeda; stock or other ownership interests: Intuitive Surgical and Teladoc. Edgardo S. Santos reports: advisory board or panel/consultant: AZ, AbbVie, Regeneron, Novartis, Johnson & Johnson, BI, Novocure, and EMD Serono; speaker bureau: Amgen, AZ, BMS, BI, Lilly, Pharmacosmos, Jazz Pharmaceuticals, Johnson & Johnson, Merck, Pfizer, Regeneron, Coherus, Takeda, and Novocure.
Ethics Approval
The MARIPOSA and COCOON studies were conducted in accordance with the principles of the Declaration of Helsinki and the Good Clinical Guidelines of the International Council for Harmonisation. The protocol and amendments were approved by the institutional review board at each study site.
Consent to Participate
All patients provided written informed consent for these studies.
Consent for Publication
Not applicable.
Availability of Data and Material
The data sharing policy of Johnson & Johnson is available at https://innovativemedicine.jnj.com/our-innovation/clinical-trials/transparency. As noted on this site, requests for access to the study data can be submitted through the Yale Open Data Access (YODA) Project site at http://yoda.yale.edu.
Code Availability
Not applicable.
Authors’ Contributions
DN: conceptualization; data curation; writing (original draft); and writing (review and editing). ESS: conceptualization; data curation; writing (original draft); and writing (review and editing).
Footnotes
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
References
- 1.Sabbah DA, Hajjo R, Sweidan K. Review on epidermal growth factor receptor (EGFR) structure, signaling pathways, interactions, and recent updates of EGFR inhibitors. Curr Top Med Chem. 2020;20(10):815–34. [DOI] [PubMed] [Google Scholar]
- 2.Robichaux J, Le X, Vijayan R, Hicks J, Heeke S, Elamin Y, et al. Structure-based classification predicts drug response in EGFR-mutant NSCLC. Nature. 2021;597(7878):732–7. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Leal J, Alexander M, Itchins M, Wright G, Kao S, Hughes B, et al. EGFR exon 20 insertion mutations: clinicopathological characteristics and treatment outcomes in advanced non-small cell lung cancer. Clin Lung Cancer. 2021;6:e859–69. [DOI] [PubMed] [Google Scholar]
- 4.Vyse S, Huang P. Targeting EGFR exon 20 insertion mutations in non-small cell lung cancer. Signal Transduct Target Ther. 2019;4:5. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 5.Haarrison P, Vyse S, Huang P. Rare epidermal growth factor receptor (EGFR) mutations in non-small cell lung cancer. Semin Cancer Biol. 2020;61:167–79. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 6.Nee-Estuye-Evangelista CK, Andal JJ, Ang D. Frequency of epidermal growth factor receptor mutations among Filipino patients with non-small cell lung carcinoma in private tertiary care setting. PJP. 2018;3:6–11. [Google Scholar]
- 7.Lacouture ME, Anadkat MJ, Bensadoun RJ, Bryce J, Chan A, Epstein JB, et al. Clinical practice guidelines for the prevention and treatment of EGFR inhibitor-associated dermatologic toxicities. Support Care Cancer. 2011;19(8):1079–95. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 8.Rerucha CM, Ewing JT, Oppenlander KE, Cowan WC. Acute hand infections. Am Fam Physician. 2019;99(4):228–36. [PubMed] [Google Scholar]
- 9.Cho BC, Simi A, Sabari J, Vijayaraghavan S, Moores S, Spira A. Amivantamab, an epidermal growth factor receptor (EGFR) and mesenchymal-epithelial transition factor (MET) bispecific antibody, designed to enable multiple mechanisms of action and broad clinical applications. Clin Lung Cancer. 2023;24(2):89–97. [DOI] [PubMed] [Google Scholar]
- 10.Johnson & Johnson. Rybrevant® (amivantamab-vmjw) plus Lazcluze™ (lazertinib) approved in the U.S. as a first-line chemotherapy-free treatment for patients with EGFR-mutated advanced lung cancer [press release]. 2024. https://www.jnj.com/media-center/press-releases/rybrevant-amivantamab-vmjw-plus-lazcluze-lazertinib-approved-in-the-u-s-as-a-first-line-chemotherapy-free-treatment-for-patients-with-egfr-mutated-advanced-lung-cancer. Accessed 18 June 2025.
- 11.Koulouris A, Tsagkaris C, Corriero AC, Metro G, Mountzios G. Resistance to TKIs in EGFR-mutated non-small cell lung cancer: from mechanisms to new therapeutic strategies. Cancers (Basel). 2022;14(14):3337. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 12.Cho BC, Lu S, Felip E, Spira AI, Girard N, Lee JS, et al. Amivantamab plus lazertinib in previously untreated EGFR-mutated advanced NSCLC. N Engl J Med. 2024;391(16):1486–98. [DOI] [PubMed] [Google Scholar]
- 13.Food & Drug Administration (FDA). FDA approves lazertinib with amivantamab-vmjw for non-small lung cancer [press release]. 2024. https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-lazertinib-amivantamab-vmjw-non-small-lung-cancer. Accessed 18 June 2025.
- 14.Johnson & Johnson. European Commission approves Lazcluze® (lazertinib) in combination with Rybrevant® (amivantamab) for the first-line treatment of patients with EGFR-mutated advanced non-small cell lung cancer [press release]. 2025. https://www.jnj.com/media-center/press-releases/european-commission-approves-lazcluze-lazertinib-in-combination-with-rybrevant-amivantamab-for-the-first-line-treatment-of-patients-with-egfr-mutated-advanced-non-small-cell-lung-cancer. Accessed 18 June 2025.
- 15.Rybrevant (amivantamab-vmjw) injection. Prescribing information. Horsham (PA): Janssen Biotech, Inc.; 2021.
- 16.Lazcluze™ (lazertinib) injection. Prescribing information. Horsham (PA): Janssen Biotech, Inc.; 2024.
- 17.Lacouture ME, Sibaud V, Gerber PA, van den Hurk C, Fernández-Peñas P, Santini D, et al. Prevention and management of dermatological toxicities related to anticancer agents: ESMO Clinical Practice Guidelines. Ann Oncol. 2021;32(2):157–70. [DOI] [PubMed] [Google Scholar]
- 18.Zereshkian A, Thawer A, Hwang DM, Cheng S. EGFR targeting TKI-related skin toxicities in a patient with darker skin: a case report. Curr Oncol. 2022;29(4):2509–15. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 19.Wu PA, Balagula Y, Lacouture ME, Anadkat MJ. Prophylaxis and treatment of dermatologic adverse events from epidermal growth factor receptor inhibitors. Curr Opin Oncol. 2011;23(4):343–51. [DOI] [PubMed] [Google Scholar]
- 20.Chu CY, Choi J, Eaby-Sandy B, Langer CJ, Lacouture ME. Osimertinib: a novel dermatologic adverse event profile in patients with lung cancer. Oncologist. 2018;23(8):891–9. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 21.Clabbers JMK, Boers-Doets CB, Gelderblom H, Stijnen T, Lacouture ME, van der Hoeven KJM, et al. Xerosis and pruritus as major EGFRI-associated adverse events. Support Care Cancer. 2016;24(2):513–21. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 22.Zhou T, Zhang Y, Ma Y, Ma W, Wu X, Huang L, et al. Comparison of aprepitant versus desloratadine for EGFR-TKI-induced pruritus: a randomized phase 2 clinical trial. Cancer. 2022;128(22):3969–76. [DOI] [PubMed] [Google Scholar]
- 23.Leighl N, Akamatsu H, Lim SM, Cheng Y, Minchom AR, Marmarelis ME, et al. Subcutaneous versus intravenous amivantamab, both in combination with lazertinib, in refractory epidermal growth factor receptor-mutated non-small cell lung cancer: primary results from the phase III PALOMA-3 study. J Clin Oncol. 2024;42(30):3593–605. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 24.Cho BC, Girard N, Sauder MB, et al. Enhanced vs standard dermatologic management with amivantamab-lazertinib in advanced NSCLC: phase 2 COCOON study. Presented at: 2024 World Conference on Lung Cancer; 7-10 September 2024; San Diego (CA). Abstract P3.12D.04.
- 25.Girard N, Li W, Spira A, Feldman J, Mak M, Sauder MB, et al. Preventing moderate to severe dermatologic adverse events in first-line EGFR-mutant advanced NSCLC treated with amivantamab plus lazertinib: early success of the COCOON trial. Presented at: 2025 European Lung Cancer Congress; 26–29 March 2025; Paris. Abstract 10MO.
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