PAPILLON Trial: Amivantamab in Lung Cancer

Year: 2023 Title: PAPILLON Subtitle: Amivantamab plus Chemotherapy in NSCLC with Epidermal Growth Factor Receptor (EGFR) Exon 20 Insertions Type of Trial: A Randomized, Open-label Phase 3 trial

Objective: To compare the efficacy, as demonstrated by progression-free survival (PFS), in participants treated with amivantamab in combination with chemotherapy, versus chemotherapy alone in participants with locally advanced or metastatic non-small cell lung cancer (NSCLC) characterized by EGFR Exon 20ins mutations.

Patients: 308

Inclusion Criteria:

  • 18 Years and older
  • Advanced NSCLC with EGFR exon 20 insertions
  • Not received previous systemic therapy

Exclusion Criteria:

  • Evidence of synchronous NSCLC disease or untreated brain metastases
  • History of spinal cord compression
  • Contraindication to the use of carboplatin or pemetrexed


  • Amivantamab + Chemotherapy (n = 153)
  • Chemotherapy Alone (Carboplatin-pemetrexed) (n = 155)

Primary Outcome:

  • Progression-free survival (Months)
  • Amivantamab + Chemotherapy: 11.4 months
  • Chemotherapy Alone: 6.7 months
  • HR for disease progression or death, 0.40; 95% CI, 0.30-0.53 (P<0.001)

Secondary Outcomes:

  • At 18 months, progression-free survival (%)
    • Amivantamab + Chemotherapy: 31%
    • Chemotherapy Alone: 3%
    • Rate ratio, 1.50; 95% CI, 1.32-1.68 (P<0.001)
  • Most Common Adverse Event (Neutropenia and anemia respectively) in Each Group (%)
    • Amivantamab + Chemotherapy: 59%
    • Chemotherapy Alone: 55%

Conclusion: The use of amivantamab-chemotherapy resulted in superior efficacy compared with chemotherapy alone as first-line treatment of patients with advanced non-small cell lung cancer with EGFR exon 20 insertions.

Reference: Zhou C et al. N Engl J Med 2023; 389:2039-2051

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