MARIPOSA enrolled patients with locally advanced or metastatic NSCLC carrying EGFR exon 19 deletion or L858R. The amivantamab-lazertinib and osimertinib groups each included 429 participants. At 37.8 months median follow-up, the combination reduced the hazard of death to 0.75 and raised three-year survival from 51% to 60%. Grade 3 or worse adverse events occurred in 80% versus 52%, particularly skin toxicity, venous thromboembolism and infusion reactions, making this both a survival advance and a higher-burden treatment.
Key findings
- Overall-survival HR was 0.75 (95% CI 0.61-0.92; P=0.005), with three-year survival of 60% versus 51%. At cutoff, 38% versus 28% remained on assigned treatment. Grade 3 or worse adverse events occurred in 80% versus 52%, without new safety signals.
Why this matters globally
This overall-survival evidence may change first-line selection worldwide. Uptake depends on infusion capacity, thrombosis prevention, dermatologic management, price and how patients value survival benefit against treatment burden.
Thai researcher contribution
Pongwut Danchaivijitr of Siriraj Hospital is a coauthor, demonstrating Thai-center participation in a global lung-cancer trial network. Thai enrollment and country-specific outcomes are not reported in the abstract.
Limitations to consider
The indexed abstract has missing EGFR text and should be checked against the full paper. Treatment burden differs substantially, severe toxicity is higher, and the sponsor developed the regimen. Quality of life, discontinuation, post-progression therapy and outcomes in frailer real-world patients remain important.