MARIPOSA
The first regimen to beat osimertinib in EGFR-mutant lung cancer, with a survival benefit exceeding a year.
PFS 23.7 vs 16.6 months (HR 0.70); OS HR 0.75 with median >12 months longer (2025). Venous thromboembolism prophylaxis and dermatologic management needed.
- Median 23.7 vs 16.6 months with Amivantamab + lazertinib compared with Osimertinib; about 7.1 months longer for half the group.
- A median is a midpoint: half the people did better than this and half did worse, so it is not a prediction for any one person.
- Put another way, the treated group had about 30 percent lower chance of the event at any given time (hazard ratio 0.7, likely range 0.58 to 0.85).
- This is a surrogate endpoint: it measures the cancer being controlled or absent on scans and tests, which often, but not always, translates into living longer.
- Median 36.7 months with Osimertinib.
- Amivantamab + lazertinib: Median not reached.
- "Not reached" means that, when the data were analysed, more than half of that group had not yet had the event, which is good news for that group.
- A median is a midpoint: half the people did better than this and half did worse.
- Put another way, the treated group had about 25 percent lower chance of the event at any given time (hazard ratio 0.75, likely range 0.61 to 0.92).
- Overall survival counts deaths from any cause, so it is the most direct measure of whether a treatment helps people live longer.
- These results apply to the people the trial enrolled: First-line EGFR-mutant NSCLC: amivantamab + lazertinib vs osimertinib. People in a different situation may not see the same effect.
- The trial selected people by a biomarker (EGFR); the result should not be assumed for people whose cancer does not have it.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
1,074 participants enrolled.
Median not reached
Source| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Progression-free survival (BICR)primary | Amivantamab + lazertinib | 429 | 23.7 months | 0.7 (0.58–0.85) | <0.001 | link |
| Osimertinib | 429 | 16.6 months | ||||
| Overall survival | Amivantamab + lazertinib | — | Median not reached | 0.75 (0.61–0.92) | 0.005 | link |
| Osimertinib | — | 36.7 months |
Patients newly diagnosed with EGFR-mutated advanced lung cancer now have a first-line option that improves survival over osimertinib, particularly if they have high-risk features. The trade-off is intravenous (now subcutaneous) infusions and considerably more skin, nail and clotting toxicity, so osimertinib alone remains reasonable for those who prioritise convenience and tolerability. Both this regimen and osimertinib plus chemotherapy (FLAURA2) are approved; there is no direct comparison.
Anyone diagnosed with advanced lung cancer should have EGFR testing before treatment, because osimertinib as the first drug gives the longest disease control, protects the brain, and is well tolerated. Chemotherapy is not the first step for these patients. The remaining questions are whether to intensify upfront (adding chemotherapy or amivantamab) and how to treat resistance when it develops.
Pages like this
not linked directly; found by shared links- TermMET amplification (bypass resistance)
Shares Amivantamab + lazertinib (first-line EGFR NSCLC), Amivantamab, MET, Acquired resistance to every therapy.
- IdeaAdd a drug when the blood test turns, without stopping the one that works
Shares Amivantamab, MET, Acquired resistance to every therapy, EGFR.
- IdeaAdd the second drug on day one when the escape route is predictable
Shares Amivantamab, MET, Acquired resistance to every therapy, EGFR.
- TermEGFR exon 19 deletion & L858R
Shares Lazertinib, Amivantamab, EGFR, Non-small-cell lung cancer.
- TermEGFR C797S
Shares Amivantamab + lazertinib (first-line EGFR NSCLC), Acquired resistance to every therapy, EGFR, Non-small-cell lung cancer.
- TrialFLAURA2
Shares FLAURA: osimertinib as first treatment for EGFR-mutated lung cancer, MARIPOSA: amivantamab plus lazertinib versus osimertinib as first treatment for EGFR-mutated lung cancer, Acquired resistance to every therapy, Non-small-cell lung cancer.
- PersonJean-Charles Soria
Shares FLAURA: osimertinib as first treatment for EGFR-mutated lung cancer, EGFR, Non-small-cell lung cancer.
- InstitutionShanghai Chest Hospital
Shares Amivantamab, MET, EGFR, Non-small-cell lung cancer.