Amivantamab

Pronunciation: am-i-vant-a-mab
Generic name: amivantamab-vmjw
Brand name: Rybrevant
Dosage form: Intravenous infusion
Drug class: Miscellaneous bispecific antibodies

Medically reviewed by Carmen Pope, BPharm. Last updated on Nov 6, 2024.

What is amivantamab?

Amivantamab (brand name Rybrevant) is a targeted treatment used to treat adults with non-small cell lung cancer (NSCLC) that has spread to other parts of the body (metastasized) or cannot be removed by surgery. Amivantamab is used in combination with other treatments or alone in those whose NSCLC has worsened on or after platinum-based chemotherapy.

• Amivantamab is FDA-approved for adults with NSCLC that contains certain abnormal epidermal growth factor receptor (EGFR) genes.

Amivantamab's mechanism of action involves targeting both EGFR and MET receptors and interfering with their signaling pathways. By targeting both these receptors, amivantamab can overcome resistance mechanisms that promote cancer growth, and trigger the immune system response against cancer cells, killing them. Amivantamab is particularly effective in patients with EGFR exon 20 insertion mutations. Amivantamab belongs to the drug class known as bispecific antibodies and it may also be called a targeted treatment (see How does Rybrevant work? for more information).

Amivantamab gained FDA approval on May 21, 2021, under the brand name Rybrevant. Amivantamab is a targeted treatment, it is not chemotherapy, although it is often used with chemotherapy treatments. There is no amivantamab generic. Its full biological name is amivantamab-vmjw.

Amivantamab uses

Amivantamab is used to treat adults with NSCLC that has spread to other parts of the body (metastatic) or cannot be removed by surgery, and has certain abnormal EGFR gene(s):

• in combination with lazertinib as a first-line treatment for NSCLC
• in combination with carboplatin and pemetrexed as a second-line treatment for NSCLC in patients whose disease has worsened on or after treatment with an EGFR tyrosine kinase inhibitor (TKI)
• in combination with carboplatin and pemetrexed as a first-line treatment for NSCLC
• alone for the treatment of NSCLC whose disease has worsened on or after platinum-based chemotherapy.

Your healthcare provider will perform a test to make sure that amivantamab is right for you.

Amivantamab side effects

The most common side effects of amivantamab are:

• cough
• shortness of breath
• feeling very tired
• rash or itchy or dry skin
• decreased appetite
• infection of the skin around your nails
• swelling anywhere in your body
• nausea, vomiting, constipation
• mouth sores
• joint or muscle pain
• abnormal blood tests
• COVID-19
• unusual feeling in the skin (such as tingling or a crawling feeling)
• reactions during the amivantamab infusion.

Serious side effects and warnings

Amivantamab can cause the following serious side effects.

Infusion-related reactions are common but can be severe or serious. The average time to onset of an infusion-related reaction is one hour from the start of the amivantamab infusion and they are more likely to occur when amivantamab is used alone, compared to when it is used in combination with other treatments. Tell your healthcare provider right away if you get any of the following symptoms during your infusion of amivantamab:

• shortness of breath
• flushing
• fever
• chest discomfort
• chills
• lightheadedness
• nausea
• vomiting.

Lung problems. Amivantamab may cause lung problems that may lead to death. Symptoms may be similar to those symptoms from lung cancer. Tell your healthcare provider right away if you get any new or worsening lung symptoms, including shortness of breath, cough, or fever.

Blood clot problems. Blood clots are a serious, but common side effect of amivantamab, when given together with another drug called lazertinib, may cause blood clots in the veins of your legs (deep vein thrombosis) or lungs (pulmonary embolism) that may lead to death. Your healthcare provider will start you on medicine to prevent blood clots for the first 4 months of treatment. Tell your healthcare provider right away if you have any signs and symptoms of blood clots, including swelling, pain or tenderness in the leg, sudden unexplained chest pain, or shortness of breath.

Skin problems. Amivantamab can cause severe rash; including blisters, peeling, skin pain and sores, redness, raised acne-like bumps, itching, and dry skin. You may use alcohol-free (such as isopropanol-free, ethanol-free) moisturizing cream to reduce the risk of skin problems. Tell your healthcare provider right away if you get any skin reactions. Your healthcare provider may treat you with a medicine(s) or send you to see a skin specialist (dermatologist) if you get skin reactions during treatment with amivantamab.

Eye problems. Amivantamab may cause eye problems. Tell your healthcare provider right away if you get symptoms of eye problems which may include:

• eye pain
• changes in vision
• inflammation of eye lids
• itchy eyes
• dry eyes
• excessive tearing
• eye redness
• sensitivity to light
• blurred vision.

Amivantamab may harm an unborn baby.

Get emergency medical help if you have signs of an allergic reaction to amivantamab, such as hives, difficulty breathing, swelling in your face or throat, or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).

This is not a complete list of side effects, and others may occur. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Related/similar drugs

Before taking this medicine

Before you receive amivantamab, tell your healthcare provider about all of your medical conditions, including if you:

• have a history of lung or breathing problems, other than cancer
• are pregnant or plan to become pregnant
• are breastfeeding or intend to breastfeed.

Pregnancy

Amivantamab can harm your unborn baby. Females who are able to become pregnant:

• Your healthcare provider should do a pregnancy test before you start treatment with amivantamab.
• You should use effective birth control (contraception) during treatment and for 3 months after your last dose of amivantamab.
• Tell your healthcare provider right away if you become pregnant or think you might be pregnant during treatment with amivantamab.

Breastfeeding

It is not known if amivantamab passes into your breast milk. Do not breastfeed during treatment and for 3 months after your last dose of amivantamab.

How is amivantamab administered?

Amivantamab will be given to you by your healthcare provider as an intravenous infusion into your vein (see How is amivantamab administered?).

Your healthcare provider will decide the time between doses as well as how many treatments you will receive.

• Your healthcare provider will give you medicines (such as an antihistamine, an antipyretic, and sometimes a glucocorticoid) before each dose of amivantamab to help reduce the risk of infusion-related reactions.
• The infusion will take several hours, depending on your dose and how many infusions you have had previously and how well you tolerated them.

Amivantamab may be given in combination with the medicines carboplatin and pemetrexed. If you have any questions about these medicines, ask your healthcare provider.

• If your treatment with amivantamab is given in combination with the medicine lazertinib, you should take your dose of lazertinib by mouth anytime before your infusion with amivantamab.

You may need frequent vision exams.

This medicine may cause rash, itching, and dry skin. Use only alcohol-free cream or lotion to treat dry skin.

Amivantamab dosing

Usual adult amivantamab dose as a single agent or in combination with lazertinib

Administer amivantamab weekly for 5 weeks. The initial dose is split and given on Day 1 and Day 2 of Week 1.

• Amivantamab is then administered every 2 weeks starting at Week 7.
• The dosage of amivantamab is weight-based:
  • Less than 80 kg: amivantamab 1050 mg IV
  • 80 kg or more: amivantamab 1400 mg IV.

Usual adult amivantamab dose in combination with carboplatin and pemetrexed

Administer amivantamab weekly for 4 weeks. The initial dose is split and given on Day 1 and Day 2 of Week 1.

• Amivantamab is then administered every 3 weeks starting at Week 7.
• The dosage is weight-based and depends on how far through the cycle you are.
  • Dose Weeks 1 to 4: Less than 80 kg: amivantamab 1400 mg IV; 80 kg or more: amivantamab 1750 mg IV
  • Dose Week 7 onwards: Less than 80 kg: amivantamab 1750 mg IV; 80 kg or more: amivantamab 2100 mg IV.

What happens if I miss a dose?

If you miss any appointments, call your healthcare provider as soon as possible to reschedule your appointment.

What happens if I miss a dose?

Call your doctor for instructions if you miss an appointment for your next injection.

What happens if I overdose?

In a medical setting, an overdose would be treated quickly.

What should I avoid while taking amivantamab?

Amivantamab can cause skin reactions. Avoid sunlight and tanning beds during treatment and for two months after your last dose. Wear protective clothing and use sunscreen (SPF 30 or higher) when outdoors.

If you have eye problems, avoid wearing contact lenses until an eye doctor can examine your symptoms.

What other drugs will affect amivantamab?

Other drugs may affect amivantamab, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. No formal drug interaction studies have been conducted with amivantamab.

Amivantamab Package Insert 

Review the Rybrevant (amivantamab) Package Insert for more detailed information about this medicine. Discuss any medical questions with your doctor or other health care provider. This is not all the information you need to know about this medicine for safe and effective use, and it does not take the place of talking to your doctor about your treatment.

Amivantamab ingredients

Amivantamab is only available under the brand name Rybrevant.

Active ingredient: amivantamab-vmjw
Inactive ingredients: EDTA disodium salt dihydrate, L-histidine, L-histidine hydrochloride monohydrate, L-methionine, polysorbate 80, sucrose, and water for injection.

Storage

Store amivantamab in a refrigerator at 2°C to 8°C (36°F to 46°F) in original carton to protect from light. Do not freeze.

Who makes amivantamab?

Janssen Biotech, Inc. makes amivantamab under the brand name Rybrevant.

Amivantamab Biosimilars

Biosimilar and interchangeable products are biological products that are highly similar to and have no clinically meaningful differences from the reference product.

Reference products

These are biological products that have already been approved by the FDA, against which biosimilar products are compared. There is 1 for amivantamab.

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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