amivantamab + dexamethasone

The combination of amivantamab and dexamethasone represents a treatment regimen where dexamethasone is used as a prophylactic medication to reduce infusion-related reactions (IRRs) associated with intravenous amivantamab administration in patients with EGFR-mutated non-small cell lung cancer (NSCLC). Amivantamab (brand name RYBREVANT) is a fully-human bispecific antibody targeting EGFR and MET with immune cell-directing activity. It's approved for treating various forms of NSCLC, particularly those with EGFR mutations. The addition of prophylactic dexamethasone to the amivantamab treatment regimen has been shown to significantly reduce the incidence of infusion-related reactions. According to the Phase 2 SKIPPirr study, prophylaxis with oral dexamethasone 8 mg taken twice daily for two days prior to treatment and one hour before infusion reduced the incidence of IRRs from a historical rate of 67.4% to 22.5%[2][4]. This represents a three-fold reduction in IRRs, with all reported reactions being Grade 1 or 2 with no patients requiring hospitalization[4]. The most common IRR-related symptoms observed with this combination were nausea (8%), dyspnea (5%), and hypotension (5%)[4]. The safety profile of amivantamab with prophylactic dexamethasone remained consistent with previous studies, showing no significant increase in adverse events[4]. This prophylactic approach is considered an important advancement in improving the treatment experience for patients receiving intravenous amivantamab, potentially allowing them to continue therapy with fewer interruptions[2][4]. Amivantamab itself has multiple FDA approvals for NSCLC treatment, including in combination with chemotherapy for EGFR exon 20 insertion mutations and in combination with lazertinib for EGFR-sensitizing mutations[5]. The addition of prophylactic dexamethasone represents an important supportive care strategy rather than a distinct therapeutic combination.