Rybrevant
Rybrevant (amivantamab-vmjw) is an FDA approved injection used to treat adults with non-small cell lung cancer (NSCLC) that has certain EGFR mutations. It's given as an infusion through your vein (IV), and your dosing schedule depends on the type of lung cancer being treated. You also might receive it with other cancer medications. Common side effects include infusion-related reactions, rash, tiredness, and skin infections around the nails.
What is Rybrevant (amivantamab)?
What is Rybrevant (amivantamab) used for?
Adults with advanced or metastatic NSCLC with certain EGFR mutations:
- Used with lazertinib as a first-choice treatment
- Used with carboplatin and pemetrexed if the cancer has gotten worse or it didn't respond well to EGFR inhibitors
- Used with carboplatin and pemetrexed as a first-choice treatment
- Used alone if the cancer has gotten worse or didn't respond well to platinum-based chemotherapy
How Rybrevant (amivantamab) works
Rybrevant (amivantamab) is a bispecific EGFR- and MET-directed antibody. It targets two proteins called EGFR and MET, which can help certain lung cancer cells grow and spread.
By attaching to these proteins, Rybrevant (amivantamab) blocks signals that tell cancer cells to grow. It also helps your immune system find and destroy cancer cells, which can help slow tumor growth.
Drug facts
| Common Brands | Rybrevant |
|---|---|
| Drug Class | Bispecific EGFR- and MET-directed antibody |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | No lower-cost generic available |
| Availability | Prescription only |
Side effects of Rybrevant (amivantamab)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
Used with lazertinib:
- Rash
- Infected skin around the nail
- Muscle and joint pain
- Mouth sores
- Swelling
- Tingling sensation
- Tiredness
- Diarrhea
- Constipation
- COVID-19
- Dry skin
- Bleeding
- Reduced appetite
- Itchy skin
- Nausea
- Changes in certain blood tests
Used with carboplatin and pemetrexed:
- Rash
- Infected skin around the nail
- Tiredness
- Nausea
- Mouth sores
- Constipation
- Swelling
- Reduced appetite
- Muscle and joint pain
- Vomiting
- COVID-19
- Changes in certain blood tests
Used alone:
- Rash
- Infected skin around the nail
- Muscle and joint pain
- Shortness of breath
- Nausea
- Tiredness
- Swelling
- Mouth sores
- Cough
- Constipation
- Vomiting
- Changes in certain blood tests
Less Common Side Effects
Used with lazertinib:
- Vomiting
- Stomach pain
- Hemorrhoids
- Fever
- Dizziness
- Headache
- Eye infection
- Cough
- Shortness of breath
- Trouble sleeping
Used with carboplatin and pemetrexed:
- Itchy skin
- Dry skin
- Fever
- Diarrhea
- Bleeding
- Cough
- Shortness of breath
Used alone:
- Dry skin
- Diarrhea
- Stomach pain
- Hemorrhoids
- Fever
- COVID-19
- Reduced appetite
- Pneumonia
- Bleeding
- Cough
- Shortness of breath
- Weight loss
- Dizziness
- Trouble sleeping
Rybrevant (amivantamab) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Infusion-related reactions: shortness of breath, fever, chills, nausea, vomiting, flushing, chest discomfort, lightheadedness, facial swelling, facial numbness, rash, hives, itching, stomach cramps, headache
- Lung problems: shortness of breath, cough, fever
- Blood clot problems (when used 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
The following Rybrevant (amivantamab) 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 NSCLC for certain adults
- Works in a more targeted way than traditional chemotherapy
- Typically given every 1 to 3 weeks
Cons
- Commonly causes rash and nail problems
- Needs to be infused through the vein at a clinic or hospital
- Long infusion times, especially for the first few treatments
Pharmacist tips for Rybrevant (amivantamab)
- Rybrevant (amivantamab) infusions can take several hours, especially during the first few treatments. Bring something to read, watch, or do during your appointment.
- Keep all of your Rybrevant (amivantamab) treatment appointments. If you miss an appointment, call your oncology care team as soon as possible to reschedule.
- If you're also taking lazertinib, take it before your Rybrevant (amivantamab) infusion. Follow your care team's instructions on when to take it.
- Infusion-related reactions are common with Rybrevant (amivantamab). Tell your oncology care team right away if you have symptoms like fever, chills, shortness of breath, nausea, flushing, chest discomfort, dizziness, or vomiting.
- Rybrevant (amivantamab) can cause skin problems, including rash. Wear broad-spectrum sunscreen when going outside and limit sun exposure during and for 2 months after your last treatment with this medication. Also apply moisturizer regularly to reduce the risk of skin issues.
- Rybrevant (amivantamab) can sometimes cause an infection around your nails, called paronychia. Contact your oncology care team if you notice pain, swelling, redness, or tenderness around a nail.
- Rybrevant (amivantamab) can cause eye problems. Tell your oncologist if you have eye pain, dry eyes, redness, blurry vision, vision changes, itching, excessive tearing, or sensitivity to light.
- Contact your oncology care team right away if you develop a new cough, shortness of breath, or worsening breathing problems while taking Rybrevant (amivantamab).
- Pregnancy: Rybrevant (amivantamab) can harm an unborn baby. If you’re able to become pregnant, use birth control during treatment and for 3 months after your last dose.
- Breastfeeding: Avoid breastfeeding while taking Rybrevant (amivantamab) and for 3 months after your last dose. It isn't known whether the medication passes into breast milk.
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), especially during the first few treatments. Symptoms can include shortness of breath, flushing, fever, chills, nausea, chest discomfort, low blood pressure, vomiting, or, rarely, a severe allergic reaction. These reactions usually happen within about 1 hour after the infusion starts. Most people are able to complete their infusions and continue treatment without further problems.
Your oncology team will give you medications before each infusion to help lower this risk and will monitor you closely during treatment. Tell your care team right away if you notice any symptoms during the infusion. They might slow down, pause, or stop the infusion depending on how serious the reaction is. If you have a severe allergic reaction, treatment with Rybrevant (amivantamab) might need to be stopped permanently.
Lung problems
Rybrevant (amivantamab) can cause serious lung inflammation, also called interstitial lung disease (ILD) or pneumonitis. In rare cases, this side effect can be life-threatening.
Tell your oncology care team right away if you develop new or worsening breathing problems while taking Rybrevant (amivantamab). Watch for symptoms such as shortness of breath, cough, or fever. Your oncologist might pause treatment while checking your symptoms.
Blood clots (when used with lazertinib)
- Risk factors: Taking Rybrevant (amivantamab) with lazertinib
In studies, 36% of people who received Rybrevant (amivantamab) with lazertinib developed blood clots, some of which were serious and life-threatening. These clots can form in your legs (deep vein thrombosis) or travel to your lungs (pulmonary embolism). Most blood clots happen during the first 4 months of treatment.
Your oncology care team might prescribe a blood thinner during the first few months to help lower this risk. Tell your care team right away if you have leg pain, leg swelling, chest pain, shortness of breath, or cough up blood. These can be signs of a blood clot and need urgent medical attention.
Skin problems
Rybrevant (amivantamab) commonly causes skin problems, including rash, acne-like bumps, itching, and dry skin. These reactions often start within the first few weeks of treatment and can sometimes be severe.
To help lower your risk, limit sun exposure and wear protective clothing and broad-spectrum sunscreen during treatment and 2 months after your last dose of Rybrevant (amivantamab). Using a moisturizer regularly can help prevent dry skin and reduce the risk of skin reactions. Get medical help right away if you develop severe skin peeling, blisters, sores, or a widespread rash, since these can be signs of a serious skin reaction.
Eye problems
Rybrevant (amivantamab) can cause eye problems, including dry eyes, red eyes, itchy eyes, blurry vision, eyelid inflammation, and, rarely, more serious eye conditions. These side effects can happen at any time during treatment.
Tell your oncology care team right away if you notice new or worsening eye symptoms, such as eye pain, redness, blurry vision, vision changes, sensitivity to light, or excessive tearing. Your oncologist might refer you to an eye specialist and might adjust your treatment depending on how severe the problem is.
Harm to the unborn baby
Rybrevant (amivantamab) can harm an unborn baby. If you can become pregnant, use effective birth control during treatment and for 3 months after your last dose. Talk with your oncologist about the risks and benefits of treatment if you're planning to become pregnant.
Rybrevant (amivantamab) dosage
Typical dosage for Rybrevant (amivantamab)
Rybrevant (amivantamab) is given as an infusion into a vein (IV) by a healthcare professional. Your dose depends on your body weight, the type of lung cancer being treated, and whether you're using it with other cancer medications.
In general:
- Used alone or with lazertinib
- Weight less than 80 kg: The typical dose is 1,050 mg once a week for the first 5 weeks, then every 2 weeks starting in Week 7.
- Weight 80 kg or more: The typical dose is 1,400 mg once a week for the first 5 weeks, then every 2 weeks starting in Week 7.
- Used with carboplatin and pemetrexed:
- Weight less than 80 kg: The typical dose is 1,400 mg once a week for the first 4 weeks, then 1,750 mg every 3 weeks starting in Week 7.
- Weight 80 kg or more: The typical dose is 1,750 mg once a week for the first 4 weeks, then 2,100 mg every 3 weeks starting in Week 7.
Your dose might differ if you experience side effects to Rybrevant (amivantamab).
Before each infusion, you'll receive medications to help lower the risk of infusion-related reactions. If you miss an appointment, contact your oncology team as soon as possible to reschedule.
What are alternatives to Rybrevant (amivantamab)?
Adults with advanced or metastatic NSCLC with certain EGFR mutations:
Non-small-cell lung cancer (NSCLC) in adults with specific EGFR mutations, including:
Rybrevant (amivantamab) images
