Amivantamab (Rybrevant)

Key Messages

• Canada’s Drug Agency (CDA-AMC) recommends that Rybrevant should be reimbursed by public drug plans when used in combination with carboplatin and pemetrexed for the first-line treatment of adult patients with locally advanced (not amenable to curative therapy) or metastatic non–small cell lung cancer (NSCLC) with activating EGFR exon 20 insertion (ex20ins) mutations if certain conditions are met.
• Rybrevant in combination with carboplatin and pemetrexed should only be covered to treat patients who have NSCLC with a specific EGFR gene mutation called ex20ins, have a good performance status, and the cancer has spread to other parts of the body or cannot be removed by surgery.
• Rybrevant in combination with carboplatin and pemetrexed should only be reimbursed when started in combination with platinum-based chemotherapy (i.e., carboplatin and pemetrexed), and the cost of Rybrevant is reduced. It should not be reimbursed for patients with untreated brain metastases or those who have had previous systemic therapy, adjuvant treatment (given after surgery), or neoadjuvant treatment (given before surgery) if those treatments were completed less than 6 months before the cancer worsened. Rybrevant in combination with carboplatin and pemetrexed must be prescribed by specialists with experience managing NSCLC.