Amivantamab, lazertinib, and bevacizumab: a chemotherapy-free option for patients with advanced EGFR-mutant NSCLC with acquired resistance to a third-generation EGFR TKI
Mené sur 61 patients atteints d'un cancer du poumon non à petites cellules avec mutations EGFR, de stade avancé et ayant développé une résistance aux inhibiteurs de tyrosine kinase de l'EGFR de 3ème génération (âge médian : 65 ans ; durée médiane de suivi : 9 mois), cet essai européen de phase II évalue l'efficacité, du point de vue du taux de réponse objective en semaine 12, et la toxicité d'un traitement combinant amivantamab, lazertinib et bévacizumab
Acquired resistance to third-generation EGFR tyrosine-kinase inhibitors (TKIs) is an inevitable challenge in the management of EGFR-mutant advanced non-small-cell lung cancer (NSCLC). Multiple resistance mechanisms have been identified and various strategies have subsequently been developed, yet platinum-doublet chemotherapy has long remained the standard backbone of treatment.1 Currently, promising strategies include bispecific antibody-based regimens (amivantamab and ivonescimab) combined with platinum-based chemotherapy,2,3 and TROP2-targeted antibody–drug conjugates,4 but all still involve cytotoxic agents. In the ETOP 18-21 AMAZE-lung trial published in The Lancet Respiratory Medicine,5 Ross A Soo and colleagues evaluated a triplet regimen of amivantamab, lazertinib, and bevacizumab that omitted conventional platinum-based chemotherapy in patients who progressed on a third-generation EGFR TKI. This prospective, international, multicentre, single-arm, phase 2 study enrolled 61 patients and was driven by the hypothesis that activation of the MET and angiogenesis pathways plays an important role in EGFR TKI resistance.
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The Lancet Respiratory Medicine , commentaire, 2026