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Use of RYBREVANT in Colorectal Cancer - OrigAMI-3 Study

Last Updated: 05/31/2025

SUMMARY

  • RYBREVANT (amivantamab-vmjw) is a low fucose, fully human immunoglobulin G1 (IgG1)-based bispecific antibody with immune cell-directing activity that targets epidermal growth factor receptor (EGFR) mutations and mesenchymal-epithelial transition (MET) mutations and amplifications in non-small cell lung cancer (NSCLC).1
  • Amivantamab for subcutaneous (SC) administration is a coformulation of amivantamab with recombinant human hyaluronidase PH20 (rHuPH20).2
  • OrigAMI-3 (NCT06750094) is an ongoing, phase 3, randomized, open-label, multicenter study evaluating the efficacy and safety of amivantamab SC vs cetuximab or bevacizumab intravenous (IV), both in combination with chemotherapy, as second-line (2L) treatment in patients with RAS/BRAF wild-type recurrent, unresectable, or metastatic colorectal cancer (CRC). The chemotherapy regimen consisted of FOLFIRI (combination of leucovorin calcium or levoleucovorin, 5-fluorouracil, and irinotecan hydrochloride). The dual primary endpoints are blinded independent central review (BICR)-assessed progression-free survival (PFS) per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 and overall survival (OS). Enrollment is planned for approximately 700 patients. Results have not yet been published.3,4 

ONGOING clinical study

OrigAMI-3 Study

Study Design/Methods

  • Ongoing, phase 3, randomized, open-label, multicenter study designed to assess the efficacy and safety of amivantamab SC vs cetuximab or bevacizumab IV (per investigator’s discretion), both in combination with FOLFIRI, as 2L treatment in patients with RAS/BRAF wild-type recurrent, unresectable, or metastatic CRC3,4 
    • Recruitment will be capped to ensure balanced enrollment to cetuximab or bevacizumab IV.3
  • The study design is shown in Figure: OrigAMI-3 Study Design.
  • Patients may undergo curative-intent surgery or procedure during the treatment period, if appropriate.3
    • An independent committee will review all patients prior to the intervention.

OrigAMI-3 Study Design3,4

OrigAMI-3 (ClinicalTrials.gov Identifier: NCT06750094) enrollment period: December 2024 onwards; estimated study completion: April 13, 2029.
Abbreviations: 1L, first-line; BICR, blinded independent central review; C, cycle; CR, complete response; CRC, colorectal cancer; D, day; DCR, disease control rate; dMMR, mismatch repair deficiency; DOR, duration of response; ECOG PS, Eastern Cooperative Oncology Group performance status; EGFR, epidermal growth factor receptor; EORTC Q168, European Organisation for Research and Treatment of Cancer Item 168; EORTC QLQ-C30, European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30; EORTC QLQ-CR29, European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Colorectal Cancer Module 29; EQ-5D-5L, European Quality of Life 5-Dimensions 5-Level questionnaire; FOLFIRI, combination of leucovorin calcium or levoleucovorin, 5-fluorouracil, and irinotecan hydrochloride; HER2, human epidermal growth factor receptor 2; IA, investigator-assessed; ILD, interstitial lung disease; IV, intravenous; MET, mesenchymal-epithelial transition; MSI-H, microsatellite instability-high; ORR, objective response rate; OS, overall survival; PD, progressive disease; PFS, progression-free survival; PFS2, PFS after first subsequent therapy; PR, partial response; PRO, patient-reported outcome; Q2W, every 2 weeks; QW, once weekly; R, randomization; RECIST, Response Evaluation Criteria in Solid Tumors; rHuPH20, recombinant human hyaluronidase; SC, subcutaneous; SD, stable disease; TTF, time to treatment failure; VEGF, vascular endothelial growth factor; WT, wild-type.
aPatients received prior 1L regimen that must be fluoropyrimidine- and oxaliplatin-based therapy ± anti-VEGF treatment.
bBrain metastases that are definitively and locally treated, clinically stable, and asymptomatic for ≥2 weeks.
cAmivantamab SC was co-formulated with 2000 U/mL rHuPH20.
d2240 mg if body weight ≥80 kg.
eLeft-sided CRC is defined as a primary tumor arising from the splenic flexure, descending colon, sigmoid colon, rectosigmoid, or rectum; right-sided CRC is defined as a primary tumor arising from the cecum, ascending colon, or transverse colon.
fStart of therapy to disease progression.
gFor patients who undergo curative-intent surgery/procedure during the treatment period, preintervention imaging will be used to determine the best response of CR, PR, or SD, and postintervention tumor assessments will be used to determine the time and location of PD (eg, recurrence at the site of resection or a distant new lesion).

Literature Search

A literature search of MEDLINE®, Embase®, BIOSIS Previews®, and Derwent Drug File (and/or other resources, including internal/external databases) was conducted on 29 May 2025.

References

1 Moores SL, Chiu ML, Bushey BS, et al. A novel bispecific antibody targeting EGFR and cMet is effective against EGFR inhibitor-resistant lung tumors. Cancer Res. 2016;76(13):3942-3953.  
2 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.  
3 Hecht JR, Élez E, Eng C, et al. OrigAMI-3: a randomized, phase 3 study of amivantamab plus FOLFIRI vs cetuximab or bevacizumab plus FOLFIRI in participants with recurrent, unresectable, or metastatic RAS/BRAF wild-type colorectal cancer. Poster presented at: American Society of Clinical Oncology (ASCO) Annual Meeting; May 30-June 3, 2025; Chicago, IL.  
4 Janssen Research & Development, LLC. A randomized, open-label phase 3 study of amivantamab + FOLFIRI versus cetuximab/bevacizumab + FOLFIRI in participants with KRAS/NRAS and BRAF wild-type recurrent, unresectable or metastatic colorectal cancer who have received prior chemotherapy. In: ClinicalTrials.gov [Internet]. Bethesda (MD): National Library of Medicine (US). 2000- [cited 2025 May 29]. Available from: https://clinicaltrials.gov/study/NCT06750094 NLM Identifier: NCT06750094.