Pronunciation: RYE–breh–vant
Generic name: amivantamab-vmjw
Dosage form: Intravenous infusion
Drug class: Miscellaneous bispecific antibodies

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

What is Rybrevant?

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. Rybrevant is used in combination with other treatments or alone in those whose NSCLC has worsened on or after platinum-based chemotherapy. 

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

Rybrevant's mechanism of action involves targeting both EGFR and MET receptors and interfering with their signaling pathways. By targeting both these receptors, Rybrevant can overcome resistance mechanisms that promote cancer growth, and trigger the immune system response against cancer cells, killing them. Ryebrevant is particularly effective in patients with EGFR exon 20 insertion mutations. Rybrevant 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).

Rybrevant gained FDA approval on May 21, 2021. Rybrevant is a targeted treatment, it is not chemotherapy, although it is often used with chemotherapy treatments. There is no Rybrevant generic.

Rybrevant uses

Rybrevant 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 Rybrevant is right for you.

Rybrevant side effects

The most common side effects of Rybrevant 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 Rybrevant infusion.

Serious side effects and warnings 

Rybrevant 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 Rybrevant infusion and they are more likely to occur when Rybrevant 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 Rybrevant:

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

Lung problems. Rybrevant 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 Rybrevant, 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. Rybrevant 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 Rybrevant. 

Eye problems. Rybrevant 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.

Rybrevant may harm an unborn baby.

Get emergency medical help if you have signs of an allergic reaction to Rybrevant, 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.

Before taking this medicine

Before you receive Rybrevant, 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

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

Pregnancy

Rybrevant may harm an unborn baby. Females who are able to become pregnant may need a pregnancy test to make sure they are not pregnant before treatment. Use birth control while using this medicine and for at least 3 months after your last dose. Tell your doctor if you become pregnant or think you may be pregnant.

Breastfeeding

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

How is Rybrevant administered?

Rybrevant will be given to you by your healthcare provider as an intravenous infusion into your vein (see How is Rybrevant 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 Rybrevant 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.

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

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.

Rybrevant dosing

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

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

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

Usual adult Rybrevant dose in combination with carboplatin and pemetrexed

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

• Rybrevant 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: Rybrevant 1400 mg IV; 80 kg or more: Rybrevant 1750 mg IV
  • Dose Week 7 onwards: Less than 80 kg: Rybrevant 1750 mg IV; 80 kg or more: Rybrevant 2100 mg IV.

Related/similar drugs

Opdivo, Keytruda, methotrexate, pembrolizumab, cisplatin, Avastin, Tagrisso

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 Rybrevant?

Rybrevant 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 Rybrevant?

Other drugs may affect Rybrevant, 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 Rybrevant.

Rybrevant Package Insert 

Review the Rybrevant 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.

Rybrevant ingredients

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 Rybrevant 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 Rybrevant?

Janssen Biotech, Inc. makes Rybrevant.

Rybrevant 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 Rybrevant.

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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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