Rybrevant: New Drug For Non-Small Cell Lung Cancer
- Rybrevant is a new treatment for non-small cell lung cancer with a specific lung cancer mutation.
- It targets cancer cells directly, potentially reducing side effects compared to traditional chemotherapy.
- Treatment involves regular infusions, with monitoring for effectiveness and side effects.
- Studies show that it can extend the time it takes for the cancer to grow and spread potentially increasing how long you can live with a better quality of life.
The drug has been approved for non-small lung cancer (NSCLC) that has a specific genetic mutation your doctor can identify through testing.
Read More- Your cancer is spread or cannot be removed by surgery
- You have a specific gene mutation known as EGFR exon 20 insertion, which is a genetic change in lung cancer cells that affects how the cells grow and respond to treatments.
- Your cancer has gotten worse during or after chemotherapy with a medicines that contain platinum
Related: Immunotherapy in Lung Cancer
What is Rybrevant?
Rybrevant is a medicine used to treat NSCLC that has a very specific genetic mutation. If your doctor orders a test that determines you have this mutation, Rybrevant could be a very effective drug for you.
“When a patient comes in, we immediately sequence the tumor. We are doing panels that might include three or four or 500 genes, the ones that are most likely. Some sort of next generation approach is the best standard of care these days – it has to be done,” Dr. Herbst explains.
The active ingredient in Rybrevant is called amivantamab-vmjw. It belongs to a class of drugs known as biologics that are made from living cells.
The drug works like a guided missile, finding and sticking to the bad cancer cells. It targets and attaches to two specific proteins on cancer cells, disrupting their growth signals and activating the immune system to fight the cancer.
Once it finds its target, it blocks signals the cells need to grow and spread. This stops the cancer from getting worse and helps patients feel better for a longer time.
Rybrevant is different from older cancer treatments because it is a targeted drug therapy. It doesn’t just attack all rapidly dividing cells in the way traditional chemotherapy does. Instead, it goes after the cancer cells with the mutation it was designed to treat while avoiding the healthy surrounding cells. This means it can be more effective and might have fewer side effects than other treatments.
The mutation Rybrevant treats is found in approximately 2% to 3% of NSCLC patients.
This represents a tiny proportion of lung cancer patients, but Dr. Herbst says having a targeted option is very significant to them.
“What if it is you or your wife or daughter or uncle?” He says.”Certainly the presence or absence now of having a mutation in the gene is big and we’re ratcheting down to a specific level of personalization.”
Related: Managing Stage 4 NSCLC
What is treatment with Rybrevant like?
Doctors give Rybrevant to patients through an infusion, which means the medicine is delivered directly into the bloodstream via a vein, similar to getting an IV drip. You go to a hospital or a clinic, where you rest as the drug is given by a healthcare professional.
Treatment is usually given once every few weeks or by a schedule set up by your doctor. The exact timing is based on your condition and how well you respond to the treatment. Sessions usually last a few hours.
Before starting Rybrevant and during the treatment, doctors will perform tests to make sure the therapy is working and keep an eye on you for any side effects. Your doctor will adjust the treatment if necessary.
What results can I expect?
Rybrevant is not a cure.
But Dr. Herbst explains why he thinks it’s an improvement over chemo.
“Chemotherapy is like a cluster bomb that kills a lot of tumor cells maybe, but it also kills a lot of normal cells. And the response rates used to be 20 or 30%. Now you’re using something that’s more laser guided and then your chance of response can go up to 60, 70 or 80%,” he says.
In a study named PAPILLON, people with the targeted gene mutation lived longer without their cancer getting worse when they used Rybrevant along with chemotherapy.
On average, study participants had about 11.4 months before their cancer progressed, compared to 6.7 months for those who only received chemotherapy.
In other words, Rybrevant could add nearly 5 extra months where the cancer does not grow or spread. And put another way, patients taking the drug can have up to 70% more time without their cancer growing or spreading compared to those who only receive chemotherapy.
However, over time, the cancer can sometimes start growing again despite treatment. When this happens it means the cancer has become resistant to Rybrevant.
“Resistance will often develop. That’s a problem,” Herbst says. “We want to figure out why the tumor is resisting and what to do next. So that’s the next challenge.”
If the cancer does grow and spread again, your doctor may need to look for new treatments. This could include trying other drugs that work differently, participating in clinical trials for new treatments, or combining various therapies to try to outsmart the cancer.
Related: Hopeful New Lung Cancer Survival Statistics
Does Rybrevant have side effects?
Common side effects include:
- Rash
- Nail damage
- Mouth sores
- An immediate Infusion-related reaction
- Fatigue
- Swelling
- Constipation or diarrhea
- Decreased appetite
- Nausea/vomiting
- Sun sensitivity
Many of Rybrevant’s side effects are mild.
“They may go away in a few days or persist for a long term. We work with patients to manage them,” Dr. Herbst says.
What you experience can vary depending on your age, overall health, and diagnosis. You can talk to your doctor if something continues to bother you.
It’s also possible to have a more serious reaction to Rybrevant.
They are quite rare but include:
- Vision changes like dry eyes or blurry vision
- Severe allergic reaction that can include swelling under your eyelids, lips, hands, or feet or tongue, mouth, or throat
- Breathing issues
- Blood-related problems such as changes in the levels of certain blood cells, including a decrease in white blood cells (which fight infection), red blood cells (which carry oxygen), and platelets (which help blood clot). These changes can increase the risk of infection.
It’s also worth noting that this drug isn’t recommended for women who are pregnant, could become pregnant, or breastfeeding mothers.
Questions for your doctor
- Should I be tested to see if Rybrevant could work for me?
- What results can I expect from taking the drug?
- How will we manage side effects?
- If Rybrevant stops working, what are my options?
- What part of my treatment will be covered by insurance and how much will I pay out of pocket?
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