Ep. 4: Managing Toxicities in MARIPOSA: Mitigating Treatment-Related Adverse Events
Joshua Sabari, MD, of NYU Langone Health, and panelists reviewed practical aspects of subcutaneous amivantamab administration, drawing on PALOMA-3 and other trials. The focus was on improving clinic efficiency and patient convenience.
Enhancing Patient Experience
Danny Nguyen, MD, of City of Hope, highlighted that subcutaneous delivery dramatically reduces time spent in the clinic, enhancing quality of life. Patients benefit from shorter visits while clinicians in busy oncology units gain efficiency.
Subcutaneous therapy greatly mitigates infusion-related reactions. Alexander Spira, MD, PhD, FACP, FASCO, of NEXT Oncology, noted that the combination of premedication, prophylactic anticoagulation, and proactive rash management helps treatment-related minimize adverse events.
Panelists emphasized patient education and support. Edgardo Santos, MD, FACP, FASCO, of the Oncology Institute of Hope and Innovation, explained that nurses play a key role in reinforcing mitigation strategies, ensuring that patients adhere to skin care, edema management, and venous thromboembolism prophylaxis.
Increasing Efficiency and Preserving Safety
Early evidence suggests that subcutaneous administration may maintain efficacy and improve tolerability. Eric Singhi, MD, of The University of Texas MD Anderson Cancer Center, noted hints of improved overall survival, although no definitive conclusions can yet be made.
Beyond patient convenience, the panel noted operational benefits, including streamlined infusion scheduling and reduced resource usage. Subcutaneous therapy allows more patients to receive care efficiently without compromising safety.
The transition to subcutaneous delivery represents a paradigm shift in EGFR-positive non–small cell lung cancer management. Panelists anticipate broader adoption, combining robust survival benefits with enhanced patient-centered care.