Rybrevant
Rybrevant (amivantamab-vmjw) is an injectable medication used for adults with non-small cell lung cancer (NSCLC) with certain mutations in the epidermal growth factor receptor (EGFR) gene. The medication is given as an intravenous infusion through your vein (IV), and how often you receive it depends on what you’re being treated for. You also might receive it with other cancer medications. Some common side effects of Rybrevant (amivantamab) include infusion-related reactions, rash, feeling tired, and infected skin around the nail.
What is Rybrevant (amivantamab)?
What is Rybrevant (amivantamab) used for?
Adults with locally advanced or metastatic NSCLC with certain EGFR mutations:
In combination with lazertinib as a first-choice treatment
In combination with carboplatin and pemetrexed as a second-choice treatment for those whose condition has worsened or didn't respond well to EGFR tyrosine kinase inhibitor
In combination with carboplatin and pemetrexed as a first-choice treatment
Given alone for those whose condition has worsened or didn’t respond well to platinum-based chemotherapy
How Rybrevant (amivantamab) works
Rybrevant (amivantamab) is a bispecific EGF receptor-directed and MET receptor-directed antibody. As a bispecific monoclonal antibody, it targets proteins on tumor cells called EGFR and MET. MET and EGFR are proteins in the body involved in signaling cells to grow and divide.
In certain lung cancers, mutations (changes) in specific genes lead to abnormal MET and EGFR proteins. This causes cells to grow out of control. Rybrevant (amivantamab) works by attaching (binding) to EGFR and MET proteins, blocking the tumor from growing, and alerting the immune system to destroy those abnormal cells
Drug Facts
What are the side effects of Rybrevant (amivantamab)?
Common Side Effects
- Rash
- Infected skin around the nail
- Muscle and joint pain
- Sores in the mouth
- Swelling of hands, ankles, feet, face, or all of your body
- Unusual feeling in the skin (such as tingling or a crawling feeling)
- Feeling very tired
- Diarrhea
- Constipation
- COVID-19
- Dry skin
- Bleeding
- Decreased appetite
- Itchy skin
- Nausea
- Changes in certain blood tests
- Vomiting
- Shortness of breath
- Cough
Other Side Effects
- Hemorrhoids
- Stomach pain
- Fever
- Pneumonia
- Weight loss
- Dizziness
- Insomnia
- Headache
- Pink eye
- Eye problems
Serious Side Effects
- Infusion-related reactions: shortness of breath, fever, chills, nausea, flushing, chest discomfort, lightheadedness, vomiting
- Lung problems: shortness of breath, cough, fever
- Blood clot problems (when taken together with lazertinib): swelling, pain, or tenderness in the leg; sudden unexplained chest pain, shortness of breath
- Skin problems: severe rash, blisters, peeling, skin pain, sores, redness, raised acne-like bumps, itching, dry skin
- Eye problems: eye pain, inflammation of eyelids, dry eyes, eye redness, blurred vision, changes in vision, itchy eyes, excessive tearing, sensitivity to light
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Dry cough, shortness of breath or trouble breathing
- Eye pain, redness, irritation, or discharge with blurry or decreased vision
- Infusion reactions—chest pain, shortness of breath or trouble breathing, feeling faint or lightheaded
- Redness, blistering, peeling, or loosening of the skin, including inside the mouth
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Bone, joint, or muscle pain
- Constipation
- Fatigue
- Nail infection—redness, swelling, warmth, or pain around the nail
- Nausea
- Pain, redness, or swelling with sores inside the mouth or throat
- Swelling of the ankles, hands, or feet
Pros and cons of Rybrevant (amivantamab)
Pros
Recommended option for non-small cell lung cancer (NSCLC) in certain adults
Works in a more targeted way than traditional chemotherapy
Lasts a long time in the body, so it doesn’t need to be taken every day
Cons
Commonly causes rash, infected skin around the nails, and serious infusion-related reactions
Needs to be infused through the vein at an infusion center or clinic
Long infusion times, especially for the first few treatments
Pharmacist tips for Rybrevant (amivantamab)
Infusion-related reactions are a common side effect of Rybrevant (amivantamab). Be on the lookout for symptoms including shortness of breath, fever, chills, nausea, flushing, chest discomfort, lightheadedness, and vomiting. Alert your oncology care team immediately so they can manage your symptoms and make adjustments to your infusion.
Rybrevant (amivantamab) can cause certain skin reactions. To lower the risk of these reactions, apply an alcohol-free moisturizer to your skin. Limit sun exposure during and for 2 months after your last treatment with this medication. Also, wear protective clothing and broad-spectrum sunscreen when going outside.
Rybrevant (amivantamab) can sometimes cause an infection in the skin around your nails, called paronychia. Contact your oncology care team if you have signs or symptoms of paronychia such as pain, tenderness, or swelling around the nail.
Rybrevant (amivantamab) can cause eye problems. Let your oncologist know if you experience symptoms such as eye pain, inflammation of the eyelids, dry eyes, eye redness, blurred vision, changes in vision, itchy eyes, excessive tearing, or sensitivity to light. Your oncologist might refer you to see an eye specialist.
Rybrevant (amivantamab) can cause harm to an unborn baby. Your oncologist will have you take a pregnancy test before you start this medication. If you’re able to become pregnant, make sure to use birth control during treatment and for 3 months after your last dose. Tell your oncologist right away if you get pregnant during treatment with Rybrevant (amivantamab).
Frequently asked questions about Rybrevant (amivantamab)
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What are the risks and warnings for Rybrevant (amivantamab)?
Rybrevant (amivantamab) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Infusion-related reactions
Risk factors: First dose of Rybrevant (amivantamab)
Infusion-related reactions are very common with Rybrevant (amivantamab). Most of the time, people react with the first dose. In studies, the median time to an infusion reaction happening was 1 hour after the start of the infusion. Half of the people experienced these reactions within the first hour, and half of the people experienced them after. Most people were able to complete their infusions and continue treatment without further problems.
But in rare cases, people had to go to the hospital and receive urgent treatment for the reaction. Notify your oncology care team if you have symptoms including shortness of breath, flushing, fever, chills, nausea, chest discomfort, lightheadedness, and vomiting. They’ll pause the infusion and give you medication to manage your symptoms. If the infusion reaction isn’t too serious, they’ll slow down the Rybrevant (amivantamab) infusion to make sure you’re handling it well.
Lung problems
Lung problems have occurred in some people taking Rybrevant (amivantamab). In rare cases, this can be life-threatening. Tell your oncologist right away if you get any new or worsening symptoms like shortness of breath, cough, or fever. Your oncologist will probably have you stop taking Rybrevant (amivantamab) while they check on your lungs.
Blood clots (if used in combination with lazertinib)
Risk factors: Taking Rybrevant (amivantamab) in combination with lazertinib
In clinical studies, 36% of people who received Rybrevant (amivantamab) in combination with lazertinib developed blood clots, some of which were serious and life-threatening. To reduce this risk, you will likely use medication to prevent blood clots during the first 4 months of treatment with Rybrevant (amivantamab) and lazertinib.
Watch out for signs and symptoms of blood clots in your legs (deep vein thrombosis) or lungs (pulmonary embolism). These symptoms include swelling, pain or tenderness in the leg, sudden unexplained chest pain, and shortness of breath.
Skin problems
Rybrevant (amivantamab) can cause severe rash. Notify your oncologist if you notice blisters, peeling, skin pain and sores, redness, raised acne-like bumps, itching, and dry skin. To prevent dry skin and reduce the risk of these skin reactions, use alcohol-free moisturizers on your skin. It's also recommended to limit sun exposure and wear protective clothing and broad-spectrum sunscreen during treatment and 2 months after the last dose of Rybrevant (amivantamab). If you do experience a rash, your oncologist might recommend medication to treat it, or refer you to a dermatologist.
Eye problems
Though rare, some people taking Rybrevant (amivantamab) experienced eye problems. Let your oncologist know if you experience any eye pain
inflammation of eyelids, dry eyes, eye redness, blurred vision, changes in vision, itchy eyes, excessive tearing, or sensitivity to light. They might refer you to see an eye specialist.
Harm to the unborn baby
Based on how the medication works, Rybrevant (amivantamab) can cause harm to an unborn baby. If you’re able to have children, your oncologist will ask you to do a pregnancy test before starting this medication. It's also recommended to use birth control during treatment and until 3 months after stopping the medication. Alert your oncology care team right away if you become pregnant while taking Rybrevant (amivantamab).
Rybrevant (amivantamab) dosage forms
Typical dosing for Rybrevant (amivantamab)
Rybrevant (amivantamab) is given as an intravenous infusion through your vein (IV) by a trained professional on your oncology team, either in a hospital or clinic setting.
Your oncologist will determine your dose of Rybrevant (amivantamab) based on your body weight. They will decide the timing between doses as well as how many treatments you will receive.
Rybrevant (amivantamab) is either given alone or with other medications including carboplatin, pemetrexed, and lazertinib. If you're prescribed lazertinib, be sure to take your dose by mouth anytime before your Rybrevant (amivantamab) infusion.
Your oncology team will give you medications before each dose of Rybrevant (amivantamab) to lower the risk of infusion-related reactions. If you miss any appointments, call your oncology team as soon as possible to reschedule your appointment.
Rybrevant (amivantamab) images
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References
Best studies we foundAmerican Cancer Society. (n.d.). Targeted therapy.
American Cancer Society. (2019). How chemotherapy drugs work.
American Cancer Society. (2023). Monoclonal antibodies and their side effects.
American Cancer Society. (2024). Infusion or immune reactions.
American Lung Association. (2024). EGFR and lung cancer.
American Lung Association. (2024). MET and lung cancer.
Janssen Biotech, Inc. (2024). Lazcluze- lazertinib tablet, film coated [package insert]. DailyMed.
Janssen Biotech, Inc. (2024). Rybrevant- amivantamab injection [package insert]. DailyMed.
National Comprehensive Cancer Network. (2024). Metastatic non-small cell lung cancer.
Park, K., et al. (2023). Management of infusion-related reactions (IRRs) in patients receiving amivantamab in the CHRYSALIS study. Lung Cancer.
Passaro, A., et al. (2024). Amivantamab plus chemotherapy with and without lazertinib in EGFR-mutant advanced NSCLC after disease progression on osimertinib: Primary results from the phase III MARIPOSA-2 study. Annals of Oncology.
Zhang, C., et al. (2022). Platinum-based drugs for cancer therapy and anti-tumor strategies. Theranostics.
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