Lumakras (sotorasib) vs Rybrevant (amivantamab-vmjw)

Lumakras (sotorasib) is a targeted therapy specifically designed for non-small cell lung cancer (NSCLC) patients with a KRAS G12C mutation, functioning as an inhibitor that directly targets the mutant KRAS protein. Rybrevant (amivantamab-vmjw), on the other hand, is a bispecific antibody that targets both EGFR and MET receptor pathways and is used for treating NSCLC with EGFR exon 20 insertion mutations. When deciding between these two medications, it is crucial for a patient to undergo genetic testing to determine the presence of either the KRAS G12C mutation or EGFR exon 20 insertion mutations, as this will directly influence which medication is appropriate for their specific cancer profile.

Difference between Lumakras and Rybrevant

Metric	Lumakras (sotorasib)	Rybrevant (amivantamab-vmjw)
Generic name	Sotorasib	Amivantamab-vmjw
Indications	For the treatment of adults with KRAS G12C-mutated locally advanced or metastatic non-small cell lung cancer (NSCLC), as determined by an FDA-approved test, who have received at least one prior systemic therapy.	For the treatment of adult patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) exon 20 insertion mutations, as detected by an FDA-approved test, after failure of platinum-based therapy.
Mechanism of action	Targets the KRAS G12C mutation and inhibits the KRAS GTPase.	Bispecific antibody that targets EGFR and MET receptors.
Brand names	Lumakras	Rybrevant
Administrative route	Oral	Intravenous
Side effects	Diarrhea, musculoskeletal pain, nausea, fatigue, liver damage, cough, and dyspnea.	Infusion-related reactions, skin rash, paronychia, musculoskeletal pain, nausea, fatigue, edema, stomatitis, and dyspnea.
Contraindications	Hypersensitivity to sotorasib or any of the excipients.	Hypersensitivity to amivantamab-vmjw or any of its excipients.
Drug class	KRAS G12C inhibitor	Bispecific EGFR and MET antibody
Manufacturer	Amgen Inc.	Janssen Biotech, Inc.

Efficacy

Lumakras (sotorasib) Efficacy in Lung Cancer

Lumakras (sotorasib) is a medication specifically designed for the treatment of non-small cell lung cancer (NSCLC) with a particular genetic mutation known as KRAS G12C. This mutation occurs in a small subset of patients with NSCLC and is known for being particularly difficult to treat. The efficacy of Lumakras was evaluated in a phase 2 clinical trial, which demonstrated that sotorasib provided a significant benefit in terms of tumor shrinkage and disease control. Patients treated with Lumakras showed a response rate, which is a reduction in tumor size, indicating that the drug can effectively target and reduce cancerous growth in the lungs.

The clinical trial results also revealed that Lumakras could lead to a median progression-free survival (PFS) time, which is the length of time during and after medication that a patient lives with the disease without it getting worse. This suggests that Lumakras can delay the progression of NSCLC in patients with the KRAS G12C mutation. The treatment was generally well-tolerated, with manageable side effects, further supporting its efficacy in this patient population.

Rybrevant (amivantamab-vmjw) Efficacy in Lung Cancer

Rybrevant (amivantamab-vmjw) is another targeted therapy approved for the treatment of NSCLC, specifically for patients with tumors that have epidermal growth factor receptor (EGFR) exon 20 insertion mutations. These mutations are associated with a poor prognosis and resistance to conventional EGFR tyrosine kinase inhibitors. The efficacy of Rybrevant was demonstrated in a multicenter, open-label, phase 1 clinical trial, where it showed a notable response rate in patients who had received prior platinum-based chemotherapy.

Patients treated with Rybrevant experienced a reduction in tumor size, and the medication also showed a median duration of response, indicating that the effects of the treatment are sustained over a period. Moreover, Rybrevant has been associated with a median overall survival, which is a key indicator of its efficacy in extending the lives of patients with this specific type of lung cancer. The drug's approval provides a new treatment option for patients with EGFR exon 20 insertion mutations, who previously had limited targeted therapies available.

Regulatory Agency Approvals

Lumakras

European Medical Agency (EMA), European Union
Food and Drug Administration (FDA), USA
Medicines & Healthcare products Regulatory Agency (MHRA), United Kingdom

Rybrevant

European Medical Agency (EMA), European Union
Food and Drug Administration (FDA), USA

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