Hayashi H.Cho B.C.Kim Y.J.Lee S.H.Danchaivijitr P.Alip A.Xiong H.How S.H.Chang G.C.Yang J.C.H.Yamanaka Y.Nahit Şendur M.A.Prabhash K.Azuma K.Akawung A.Fennema E.Tang X.Shah S.Sethi S.Lu S.Mahidol University2026-02-252026-02-252026-04-01Lung Cancer Vol.214 (2026)01695002https://repository.li.mahidol.ac.th/handle/123456789/115291Background: Approximately 60 % of lung cancer cases occur in Asia, indicating an epidemiological disparity and need for effective therapies. Amivantamab-lazertinib is approved for first-line EGFR-mutated advanced non-small cell lung cancer (NSCLC) in many countries. In the protocol-specified final overall survival (OS) analysis of MARIPOSA (NCT04487080), amivantamab-lazertinib showed a statistically significant and clinically meaningful improvement in OS versus osimertinib (HR, 0.75; P = 0.005) among all participants. We evaluated OS for amivantamab-lazertinib versus osimertinib in Asian participants. Patients and methods: Participants with previously untreated EGFR-mutated, locally advanced/metastatic NSCLC were randomized 2:2:1 to receive amivantamab-lazertinib, osimertinib, or lazertinib (for evaluating contribution of components). Self-identified Asian race was a stratification factor. OS was a key secondary endpoint. Results: Of 1074 randomized participants, 629 self-identified as Asian (amivantamab-lazertinib:250; osimertinib:251; lazertinib:128). At a median follow-up of 38.7 months, amivantamab-lazertinib significantly prolonged OS versus osimertinib among Asian participants. Median OS was not reached (NR; 95 % CI, NR–NR) for amivantamab-lazertinib versus 38.4 months (95 % CI, 35.1–NR) for osimertinib (HR, 0.74; 95 % CI, 0.56–0.97; nominal P = 0.026). Assuming exponential distribution of OS in both arms, amivantamab-lazertinib is projected to prolong median OS among Asian participants by > 12 months versus osimertinib. At 36 months, 61 % and 53 % were alive in the amivantamab-lazertinib and osimertinib arms. Safety profile was consistent with the overall population. Conclusions: Consistent with the overall population, amivantamab-lazertinib significantly improved OS versus osimertinib among Asian participants with previously untreated EGFR-mutated advanced NSCLC, making it the first regimen to improve survival among Asian patients.Biochemistry, Genetics and Molecular BiologyMedicineArticleSCOPUS10.1016/j.lungcan.2026.1093052-s2.0-10503013461818728332