With the recent approval of subcutaneous amivantamab (Rybrevant Faspro) for certain patients with EGFR-mutated non–small cell lung cancer (NSCLC), GO2 for Lung Cancer Chief Healthcare Delivery Officer Joelle Fathi, DNP, RN, ARNP, joined Cancer Nursing Today to discuss how the use of the subcutaneous formulation may affect patients, nurses, and healthcare systems overall.
For example, there are multiple oncology nursing considerations surrounding the subcutaneous formulation, including reduced administration time and reduced administration-related reactions, Dr. Fathi said.
“First and foremost—in thinking through the patients who are on the receiving end of this medication and what they have been through up to this point—this medication offers an opportunity to regain some of their autonomy and their quality of life,” Dr. Fathi said.
In a press release, Johnson & Johnson officials highlighted that the approval of the subcutaneous formulation is a “pivotal step forward” in treatment for patients with EGFR-mutated NSCLC and highlighted several key points related to the new formulation, including survival data from the phase 3 PALOMA-3 trial presented at the American Society of Clinical Oncology (ASCO) Annual Meeting in 2024. The study showed that patients who received the subcutaneous formulation had a longer duration of response, increased progression-free survival, and increased overall survival compared with patients who received the IV formulation.
“The subcutaneous formulation had a very favorable effectiveness and safety profile,” Dr. Fathi said. “These things matter. That’s what we’re aiming for—to get the most tolerable and effective treatment to the patients at the right time.” Beyond the efficacy profile of the subcutaneous formulation, Dr. Fathi also highlighted safety data and practical considerations for oncology nurses and patients, including insights surrounding toxicities, such as venous thromboembolism.
“The safety profile of [the subcutaneous formulation] is of particular interest,” Dr. Fathi said. “It’s fascinating that there were significantly reduced administration-related reactions, not only in venous thromboembolic events, but also [in terms of] other toxicities that tend to come with chemotherapeutic agents. Any of these side effects are undesirable, but some can be more severe and fatal than others. We can’t underestimate what this improved safety profile for this subcutaneous formulation means, not only for the patients, but [also] for the providers who are administering and ordering this medication.”
In addition to the safety and efficacy data, Dr. Fathi also explained the healthcare system–level considerations surrounding the subcutaneous administration route as compared with the IV route.
“You’re not having to schedule a significant block of time for patients to come in, get settled, get an IV or have access established, and monitor them while they’re getting their IV administration,” Dr. Fathi said.
Dr. Fathi concluded that the FDA approval of the subcutaneous formulation also reflects a broader evolution in the field of oncology.
“We think about the comfort for the patients and the nurses on the side of healthcare delivery,” Dr. Fathi said. “Being able to offer a subcutaneous formulation—give people the medication and know that the chances that there’s going to be an adverse event are less with the subcutaneous versus the IV version—lessens the worry for nurses. It’s exciting to imagine how this will transform the future of how we treat patients with advanced EGFR-mutated NSCLC.”