The Butterfly Flies - Practice Changing Results of PAPILLON, First Line Chemotherapy and Amivantamab for the Treatment of NSCLC Patients with EGFR Exon 20 Insertions

• Published in: Lung cancer (Auckland) Vol. 15; pp. 49 - 54
• Main Authors: Kaakour, Dalia, Nagasaka, Misako
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01-01-2024; Dove; Dove Medical Press
• Subjects: bispecific antibody; Cancer; Care and treatment; Comparative analysis; Development and progression; egfr; Epidermal growth factor; epidermal growth factor receptor; first line therapy; Lung cancer, Non-small cell; mobocertinib; Pemetrexed; targeted therapy; Tyrosine; Asia; bispecific antibody; targeted therapy; first line therapy; mobocertinib; epidermal growth factor receptor; EGFR
• ISSN: 1179-2728; 1179-2728
• DOI: 10.2147/LCTT.S454736

Epidermal growth factor receptor (EGFR) exon 20 insertions are a rare subtype of EGFR mutations that do not respond to EGFR tyrosine kinase inhibitors developed for sensitizing mutations. In 2021, two drugs, amivantamab and mobocertinib each received FDA accelerated approval for second line use after platinum based therapy. These drugs were then brought to first line setting clinical trials; PAPILLON and EXCLAIM2. PAPILLON, which compared amivantamab plus chemotherapy to chemotherapy was positive, whereas EXCLAIM2, which compared mobocertinib to chemotherapy was negative. The PAPILLON regimen received subsequent FDA approval. In this commentary, we review the details of PAPILLON and also discuss why the rival trial, EXCLAIM2, may have failed.