Among patients with mutated, locally advanced or metastatic non-small cell lung cancer, first-line treatment with Rybrevant (amivantamab-vmjw) plus Lazcluze (lazertinib) significantly extended overall survival compared with Tagrisso (osimertinib) therapy, according to data from the phase 3 MARIPOSA study.
Findings from MARIPOSA, which were shared in a presentation at the 2025 European Lung Cancer Congress, as well as published in a news release from Johnson & Johnson, specifically evaluated patients whose disease had epidermal growth factor receptor (EGFR) exon 19 deletions (ex19del) or L858R substitution mutations.
The median overall survival, according to the news release, is expected to extend more than one year beyond the previously observed median of three years with Tagrisso, though the exact duration has not yet been reached. Moreover, this is the first and only study to demonstrate a statistically significant and clinically meaningful improvement in overall survival compared with Tagrisso.
Glossary:
Progression-free survival: the length of time during and after treatment that a patient lives with the disease, but it does not get worse.
Overall survival: the length of time from either the date of diagnosis or the start of treatment that patients are still alive.
Overall response rate: the proportion of patients who have a partial or complete response to therapy.
Duration of response: the length of time that a tumor continues to respond to treatment without the cancer growing or spreading.
“Rybrevant plus Lazcluze helps patients live longer, and the benefit keeps growing over time,” trial investigator, Dr. Nicolas Girard, said in the news release. “We see the gap between the survival curves continue to widen, which is exactly what we want to see in lung cancer treatment to improve outcomes for patients. These results reinforce that we are entering a new era for EGFR-mutated non-small cell lung cancer; with this evidence in hand, we need to ensure every patient gets the most effective treatment in the first line for the best possible chance at longer survival.”
Girard, who also presented these data at the meeting, is the head of Medical Oncology at the Institut Curie and a professor of Thoracic Oncology and Respiratory Medicine at the Paris-Saclay University, in France.
Overall survival — unlike progression-free survival, which tracks the time a treatment keeps a patient’s cancer from progressing —helps patients recognize how a therapy may impact their lifespan from the beginning of treatment. Increasing life expectancy is the most significant measure of a treatment’s effectiveness, the news release emphasizes.
Delving Into the Data: What Does it Mean?
At a median follow-up of 37.8 months, in the head-to-head comparison of data, patients who received the chemotherapy-free combination lived significantly longer than those treated with Tagrisso. The median overall survival for patients on Rybrevant plus Lazcluze has not yet been determined, indicating that survival benefits continue beyond the follow-up period. In contrast, the median overall survival for patients treated with Tagrisso was 36.7 months, which aligns with previous studies of the agent. Additionally, 56% of patients on Rybrevant plus Lazcluze were still alive at three and a half years compared with 44% of those receiving Tagrisso.
This combination therapy also improved multiple secondary outcomes versus Tagrisso, including better control of cancer spread to the brain (intracranial progression-free survival), longer duration of response in the brain and a higher response rate in brain metastases. Importantly, Rybrevant plus Lazcluze also delayed the onset of lung cancer symptoms by more than 14 months compared with Tagrisso (43.6 months versus 29.3 months).
In the news release, Dr. Joshua Bauml, vice president and Lung Cancer Disease Area Stronghold Leader of Johnson & Johnson Innovative Medicine, said: “Right now, only 20% of patients with EGFR-positive non-small cell lung cancer survive beyond five years. These MARIPOSA results suggest that Rybrevant plus Lazcluze can change this dire statistic that has been stagnant for far too long. This regimen isn’t just extending survival, it’s offering hope. By using Rybrevant plus Lazcluze first, we’re delaying the need for chemotherapy and giving patients and their families more time.”
More Information on the Combination and its Safety
Regarding safety, Rybrevant plus Lazcluze was consistent with the primary analysis of data from MARIPOSA, with side effect rates comparable with other Rybrevant regimens. With the longer-term follow-up, no new safety concerns were observed, and most side effects associated with the combination occurred early on in treatment. Research suggests that taking preventive measures during the first four months of therapy may significantly lower the risk of skin reactions, infusion-related reactions and blood clots.
The randomized phase 3 study has enrolled 1,074 patients and is examining treatment with Rybrevant plus Lazcluze versus Tagrisso and versus Lazcluze alone in the first-line treatment of patients with locally advanced or metastatic NSCLC with mutations. The primary endpoint of the study is progression-free survival, while secondary end points include overall survival, as well as overall response rate, duration of response and intracranial progression-free survival.
In October 2023, the MARIPOSA study met its primary end point, the news release concluded, showing a statistically significant and clinically meaningful improvement in progression-free survival with the investigative agent versus Tagrisso.
Rybrevant plus Lazcluze is approved in the United States, Europe and other markets around the world for patients with first-line EGFR-mutated NSCLC. These OS results will be shared with health authorities globally.
In the United States, Europe and other markets around the world, treatment with Rybrevant plus Lazcluze is approved for the first-line treatment of patients with mutated NSCLC.
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