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Last Updated: 06/03/2026

OrigAMI-4 (ClinicalTrials.gov Identifier: NCT06385080).
Abbreviations: AUC, area under the concentration-time curve; BW, body weight; C, cycle; CBR, clinical benefit rate; CPS, combined positive score; CT, computed tomography; D, day; DL0, initial dose level; DLT, dose-limiting toxicity; DOR, duration of response; ECOG PS, Eastern Cooperative Oncology Group performance status; EGFR, epidermal growth factor receptor; HNSCC, head and neck squamous cell carcinoma; HPV, human papillomavirus; ILD, interstitial lung disease; ISH, in-situ hybridization; IV, intravenous; MRI, magnetic resonance imaging; ORR, objective response rate; OS, overall survival; PD-1, programmed cell death protein 1; PD-L1, programmed cell death-ligand 1; PFS, progression-free survival; PK, pharmacokinetics; QW, weekly; Q3W, every 3 weeks; RECIST, Response Evaluation Criteria in Solid Tumors; R/M, recurrent/metastatic; RP2D, recommended phase 2 dose; SC, subcutaneous; SD, stable disease; SET, study evaluation team.
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iNeoadjuvant amivantamab SC plus pembrolizumab will be administered prior to surgery (2 cycles). Following surgery, patients will receive adjuvant radiation (with or without cisplatin) plus pembrolizumab (3 cycles), followed by adjuvant amivantamab SC plus pembrolizumab (12 cycles).
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Note: Disease was assessed at baseline and every 6 weeks (±1 week) for 1 year, then every 9 weeks thereafter using CT or MRI per RECIST v1.1. Brain imaging by MRI (or CT if MRI was contraindicated) at baseline was required for all patients with a history of brain metastasis or suspected brain metastasis, with repeat scans performed every 12 weeks (±1 week).
| Characteristic | Cohort 1 (n=102) |
|---|---|
| Median age, years (range) | 63 (30-81) |
| <65 years, n (%) | 56 (55) |
| ≥65 to <75 years, n (%) | 35 (34) |
| ≥75 years, n (%) | 11 (11) |
| Sex, n (%) | |
| Male | 79 (77) |
| Female | 23 (23) |
| Race, n (%) | |
| Asian | 45 (44) |
| White | 42 (41) |
| Black or African American | 1 (1) |
| Not reported/unknown | 14 (14) |
| Region, n (%) | |
| Eastern Asia | 42 (41) |
| North America | 29 (28) |
| Europe | 29 (28) |
| Southeastern Asia | 2 (2) |
| Median body weight, kg (range) | 61.5 (40-96) |
| <80 kg, n (%) | 93 (91) |
| ≥80 kg, n (%) | 9 (9) |
| ECOG PS score, n (%) | |
| 0 | 34 (33) |
| 1 | 68 (67) |
| History of smoking, n (%) | |
| Yes | 72 (71) |
| No | 30 (29) |
| Median time from initial head and neck diagnosis, months (range) | 21.2 (3.2-269.7) |
| Median time from recurrent/metastatic disease diagnosis, months (range) | 8.9 (0.4-43.7) |
| Primary tumor location, n (%) | |
| Oral cavity | 48 (47) |
| Larynx | 24 (24) |
| Hypopharynx | 16 (16) |
| Oropharynx | 14 (14) |
| Stage at screening, n (%) | |
| III | 4 (4) |
| IVA | 22 (22) |
| IVB | 11 (11) |
| IVC | 65 (64) |
| Site of recurrence/metastasisa, n (%) | |
| Head and neck | 66 (65) |
| Lung | 53 (52) |
| Local lymph node | 40 (39) |
| Distant lymph node | 24 (24) |
| Bone | 12 (12) |
| Liver | 7 (7) |
| Skin | 3 (3) |
| Other | 19 (19) |
| Patients with ≥1 prior therapy, n (%) | |
| Prior systemic therapy | 102 (100) |
| 1 prior line of therapy | 53 (52) |
| 2 prior lines of therapy | 49 (48) |
| Abbreviations: ECOG PS, Eastern Cooperative Oncology Group performance status; SC, subcutaneous.aPatients can be counted in >1 category. | |
| Cohort 1 (n=102) | |
|---|---|
| Received Amivantamab SC, n | 102 |
| Disposition, n (%) | |
| Ongoing treatment | 32 (31) |
| Discontinued treatment | 70 (69) |
| Disease progression | 54 (53) |
| Adverse event | 15 (15) |
| Related adverse event | 8 (8) |
| Withdrawal by patient | 1 (1) |
| Abbreviations: SC, subcutaneous | |
| Cohort 1 (n=102) | ||
|---|---|---|
| BICR-assessed response | Investigator-assessed response | |
| Median follow-up, months (range) | 11.8 (1.1-21.9) | |
| Confirmed ORR, % (95% CI) | 42 (32-52) | 47 (37-57) |
| Best response, n (%) | ||
| CR | 15 (15) | 7 (7) |
| PR | 28 (27) | 41 (40) |
| SD | 36 (35)a | 39 (38) |
| PD | 16 (16) | 9 (9) |
| NE | 7 (7) | 6 (6) |
| CBR, % (95% CI)b | 63 (53-72) | 74 (64-82) |
| Median DOR, months (95% CI) | NR (6.9-NR)c | 9.5 (6.7-NR)d |
| DOR ≥6 months, n (%) | 24 (56) | 26 (54) |
| Abbreviations: BICR, blinded independent central review; CI, confidence interval; CBR, clinical benefit rate; CR, complete response; DOR, duration of response; NE, not evaluable; NR, not reached; ORR, objective response rate; PD, progressive disease; PR, partial response; SC, subcutaneous; SD, stable disease. aIncludes non-CR/non-PD in patients with only non-target lesions at baseline and no evidence of disease in patients with no target or non-target lesions at baseline. bCBR is defined as the percentage of patients achieving a CR or PR, or durable SD (at the second disease assessment).cAmong 43 confirmed responders.dAmong 48 confirmed responders. | ||
| Subgroup | n/N | ORR (95% CI) |
|---|---|---|
| Overall | 43/102 | 42 (32-52) |
| Age | ||
| <65 years | 29/56 | 52 (38-65) |
| ≥65 years | 14/46 | 30 (18-46) |
| <75 years | 38/91 | 42 (32-53) |
| ≥75 years | 5/11 | 45 (17-77) |
| Sex | ||
| Male | 32/79 | 41 (30-52) |
| Female | 11/23 | 48 (27-69) |
| Body weight | ||
| <80 kg | 42/93 | 45 (35-56) |
| ≥80 kg | 1/9 | 11 (0-48) |
| Race | ||
| Asian | 19/45 | 42 (28-58) |
| Non-Asian | 15/43 | 35 (21-51) |
| ECOG PS | ||
| 0 | 15/34 | 44 (27-62) |
| 1 | 28/68 | 41 (29-54) |
| History of smoking | ||
| Yes | 29/72 | 40 (29-53) |
| No | 14/30 | 47 (28-66) |
| Primary tumor location | ||
| Oral cavity | 27/48 | 56 (41-71) |
| Non-oral cavity | 16/54 | 30 (18-44) |
| Prior lines of therapya | ||
| 1 | 23/53 | 43 (30-58) |
| 2 | 20/49 | 41 (27-56) |
| Abbreviations: BICR, blinded independent central review; CI, confidence interval; ECOG PS, Eastern Cooperative Oncology Group performance status; ORR, objective response rate.aPrior lines of therapy was not a prespecified subgroup. | ||
| Endpoint | Cohort 1 (n=102) |
|---|---|
| Median PFSa, months (95% CI) | 6.8 (5.2-8.3) |
| PFS rate at 6 months, % (95% CI) | 53 (43-62) |
| PFS rate at 12 months, % (95% CI) | 23 (13-35) |
| Median OS, months (95% CI) | 12.5 (10.2-16.8) |
| OS rate at 6 months, % (95% CI) | 78 (69-85) |
| OS rate at 12 months, % (95% CI) | 54 (42-64) |
| Abbreviations: CI, confidence interval; OS, overall survival; PFS, progression-free survival.aAssessed by investigator. | |
| TEAE, n (%) | Cohort 1 (n=102) |
|---|---|
| Any TEAE | 102 (100) |
| Any grade ≥3 TEAE | 61 (60) |
| Any grade 5 | 6 (6)a |
| Any serious TEAE | 40 (39) |
| Any TEAE leading to: | |
| Dose interruption | 52 (51) |
| Dose reduction | 23 (23) |
| Discontinuation | 17 (17) |
| Treatment-related discontinuation | 8 (8)b |
| Abbreviations: AE, adverse event; TEAE, treatment-emergent adverse event.aFor grade 5 TEAEs, 1 patient had treatment-related pneumonitis resulting in death. Five additional deaths due to AEs occurred, which were considered unrelated to amivantamab. bEight patients discontinued amivantamab due to treatment-related AEs for the following reasons: rash or pustular rash (n=2), blood alkaline phosphate increased (n=1), folliculitis (n=1), interstitial lung disease (n=1), paronychia (n=1), pneumonitis (n=1), stomatitis (n=1). | |
| Cohort 1 (n=102) | ||
|---|---|---|
| All Grades | Grade ≥3 | |
| Hypoalbuminemia | 51 (50) | 5 (5) |
| Rash | 38 (37) | 3 (3) |
| Dermatitis acneiform | 35 (34) | 6 (6) |
| Paronychia | 35 (34) | 2 (2) |
| Fatigue | 29 (28) | 4 (4) |
| Stomatitis | 29 (28) | 2 (2) |
| Hypocalcemia | 25 (25) | 1 (1) |
| Peripheral edema | 24 (24) | 1 (1) |
| Anemia | 22 (22) | 5 (5) |
| Weight decreased | 18 (18) | 1 (1) |
| Hypomagnesemia | 18 (18) | 1 (1) |
| Nausea | 17 (17) | 0 |
| AST increased | 16 (16) | 3 (3) |
| Diarrhea | 16 (16) | 0 |
| Lymphopenia | 15 (15) | 9 (9) |
| ALT increased | 15 (15) | 4 (4) |
| Pruritus | 15 (15) | 2 (2) |
| Administration-related reaction | 15 (15) | 0 |
| Decreased appetite | 15 (15) | 0 |
| Hypokalemia | 15 (15) | 3 (3) |
| Dyspnea | 13 (13) | 3 (3) |
| Pneumonia | 12 (12) | 6 (6) |
| Insomnia | 12 (12) | 0 |
| Asthenia | 11 (11) | 0 |
| Dizziness | 11 (11) | 0 |
| Constipation | 10 (10) | 0 |
| Pyrexia | 10 (10) | 1 (1) |
| Hypotension | 10 (10) | 0 |
| Abbreviations: ALT, alanine aminotransferase; AST, aspartate aminotransferase; TEAE, treatment-emergent adverse event. | ||
| TRAEs (≥10%), n (%) | Cohort 1 (n=102) |
|---|---|
| Hypoalbuminemia | 41 (40) |
| Rash | 38 (37) |
| Dermatitis acneiform | 34 (33) |
| Paronychia | 34 (33) |
| Stomatitis | 27 (26) |
| Fatigue | 20 (20) |
| Pruritus | 15 (15) |
| Administration-related reaction | 15 (15) |
| Diarrhea | 12 (12) |
| Hypocalcemia | 12 (12) |
| Peripheral edema | 12 (12) |
| Hypomagnesemia | 12 (12) |
| Hypokalemia | 11 (11) |
| Decreased appetite | 10 (10) |
| Abbreviations: TRAE, treatment-related adverse event. | |
| Cohort 2 (n=39) | |
|---|---|
| Median age, years (range) | 63 (39-77) |
| Sex, n (%) | |
| Male | 33 (85) |
| Female | 6 (15) |
| Race, n (%) | |
| Asian | 18 (46) |
| White | 20 (51) |
| Not reported | 1 (3) |
| ECOG PS, n (%) | |
| 0 | 17 (44) |
| 1 | 22 (56) |
| Primary tumor location, n (%) | |
| Hypopharynx | 8 (21) |
| Larynx | 7 (18) |
| Oropharynxa | 6 (15) |
| Oral cavity | 18 (46) |
| PD-L1 CPSb | |
| 1-19 | 19 (49) |
| ≥20 | 20 (51) |
| Abbreviations: ECOG PS, Eastern Cooperative Oncology Group performance status; CPS, combined positive score; HPV, human papillomavirus; PD-L1, programmed cell death-ligand 1. aPatients with HPV-positive oropharyngeal cancer were excluded; all 6 patients with oropharynx as primary tumor location were HPV-negative.bPD-L1 CPS was documented by local testing using a 22C3 antibody test. | |
| Investigator-assessed | Cohort 2 (n=39) |
|---|---|
| Confirmed ORR, % (95% CI) | 56 (40-72) |
| Best confirmed response, n (%) | |
| CR | 4 (10) |
| PR | 18 (46) |
| SD | 11 (28) |
| PD | 5 (13) |
| NEa | 1 (3) |
| Time to first response,b weeks | 9.7 |
| CBR,c % (95% CI) | 74 (58-87) |
| Median PFS, months (95% CI) | 7.7 (5-NEd) |
| Median OS, months | NEd |
| Abbreviations: CBR, clinical benefit rate; CR, complete response; NE, not evaluable; PD, progressive disease; PR, partial response; SD, stable disease.aNot evaluable.bAmong all responders. First scan occurred at week 9.cDefined as the percentage of patients with a confirmed CR or PR or durable SD at the second disease assessment.dNot estimable.Note: Treatment beyond disease progression was allowed if the patient continued to derive clinical benefit. | |
| TEAEs (≥20%) by Preferred Term, n (%) | Cohort 2 (n=39) | |
|---|---|---|
| All Grades | Grade ≥3 | |
| Associated with EGFR inhibition | ||
| Rash | 19 (49) | 5 (13) |
| Paronychia | 18 (46) | 2 (5) |
| Dermatitis acneiform | 15 (38) | 2 (5) |
| Stomatitis | 14 (36) | 2 (5) |
| Associated with MET inhibition | ||
| Hypoalbuminemia | 16 (41) | 2 (5) |
| Peripheral edema | 8 (21) | 0 |
| Other | ||
| AST increased | 15 (38) | 1 (3) |
| ALT increased | 14 (36) | 2 (5) |
| Fatigue | 11 (28) | 1 (3) |
| Hypothyroidism | 10 (26) | 0 |
| Constipation | 9 (23) | 0 |
| Hypomagnesemia | 8 (21) | 0 |
| Pneumoniaa | 8 (21) | 6 (15) |
| Abbreviations: ALT, alanine aminotransferase; AST, aspartate aminotransferase; EGFR, epidermal growth factor receptor; MET, mesenchymal-epithelial transition; TEAE, treatment-emergent adverse event.aIn addition, pneumonitis and pneumonia aspiration were each reported in 3 (8%) patients (1 patient, grade ≥3). | ||
| Characteristic | Cohort 3a (n=11)a |
|---|---|
| Median age, years (range) | 58 (39-69) |
| Sex, n (%) | |
| Male | 9 (82) |
| Female | 2 (18) |
| Race, n (%) | |
| Asian | 7 (64) |
| White | 3 (27) |
| Unknown | 1 (9) |
| Primary tumor location, n (%) | |
| Hypopharynx | 1 (9) |
| Larynx | 1 (9) |
| Oropharynx | 1 (9) |
| Oral cavity | 8 (73) |
| Abbreviation: SC, subcutaneous. | |
| TEAEs (≥20%) by Preferred Term, n (%) | Cohort 3a (n=11) | |
|---|---|---|
| All Grades | Grade ≥3 | |
| Associated with EGFR inhibition | ||
| Dermatitis acneiform | 5 (45) | 1 (9) |
| Paronychia | 5 (45) | 0 |
| Stomatitis | 5 (45) | 2 (18) |
| Rash | 4 (36) | 0 |
| Diarrhea | 3 (27) | 1 (9) |
| Associated with MET inhibition | ||
| Hypoalbuminemia | 3 (27) | 0 |
| Other | ||
| Fatigue | 5 (45) | 1 (9) |
| Hypophosphatemia | 4 (36) | 0 |
| Neutropenia | 3 (27) | 2 (18) |
| Pneumonia | 3 (27) | 2 (18) |
| Leukopenia | 3 (27) | 1 (9) |
| Myalgia | 3 (27) | 1 (9) |
| ALT increased | 3 (27) | 0 |
| Anemia | 3 (27) | 0 |
| Back pain | 3 (27) | 0 |
| Constipation | 3 (27) | 0 |
| Hypokalemia | 3 (27) | 0 |
| Nausea | 3 (27) | 0 |
| Pyrexia | 3 (27) | 0 |
| Abbreviations: ALT, alanine aminotransferase; EGFR, epidermal growth factor receptor; MET, mesenchymal-epithelial transition; SC, subcutaneous; TEAE, treatment-emergent adverse event. | ||
| Efficacy Outcome | Cohort 3a (n=11) |
|---|---|
| ORR, % (95% CI) | 64 (31-89) |
| Best response, n | |
| CR | 1a |
| PR | 8 |
| Not evaluable/unknown | 2 |
| Median DOR, months | NR |
| Median time to first response, weeks (range) | 6.6 (6.1-14.6) |
| Tumor shrinkage of target lesions, n | 9 |
| Among confirmed responders, n (%) | 7 (64) |
| Treatment ongoing, n | 4 |
| Median PFS, months | NE |
| Median OS, months | NE |
| Abbreviations: CI, confidence interval; CR, complete response; DOR, duration of response; NE, not estimable; NR, not reached; ORR, objective response rate; OS, overall survival; PFS, progression-free survival; PR, partial response; SC, subcutaneous. aResponse ongoing. | |
A literature search of MEDLINE®
| 1 | Leighl NB, Akamatsu H, Lim SM, et al. Subcutaneous versus intravenous amivantamab, both in combination with lazertinib, in refractory epidermal growth factor receptor-mutated non-small cell lung cancer: primary results from the phase III PALOMA-3 study. J Clin Oncol. 2024;42(30):3593-3605. |
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