Rybrevant

Rybrevant (amivantamab-vmjw) is a targeted cancer medicine used to treat non-small cell lung cancer (NSCLC) in adults whose cancer has certain changes (mutations) in a gene called EGFR. It is a bispecific antibody, meaning it attaches to two targets at once: the EGFR and MET proteins on cancer cells.

Rybrevant is given as an intravenous (IV) infusion into a vein by a healthcare provider. A subcutaneous (under-the-skin) version called Rybrevant Faspro (amivantamab and hyaluronidase-lpuj) is also available and is injected in about 5 minutes.

Rybrevant received its first FDA approval on May 21, 2021. Rybrevant Faspro was approved on December 17, 2025. There is no generic version of Rybrevant.

Rybrevant is used to treat locally advanced or metastatic non-small cell lung cancer (NSCLC) in adults. A healthcare provider uses an FDA-approved test to check the cancer for EGFR mutations before treatment. Rybrevant is approved:

• In combination with lazertinib, for the first-line (initial) treatment of NSCLC with EGFR exon 19 deletions or exon 21 L858R substitution mutations.
• In combination with carboplatin and pemetrexed, for NSCLC with EGFR exon 19 deletions or exon 21 L858R mutations whose disease has progressed on or after treatment with an EGFR tyrosine kinase inhibitor.
• In combination with carboplatin and pemetrexed, for the first-line treatment of NSCLC with EGFR exon 20 insertion mutations.
• As a single agent, for NSCLC with EGFR exon 20 insertion mutations whose disease has progressed on or after platinum-based chemotherapy.

It is not known whether Rybrevant is safe and effective in children.

Both contain the antibody amivantamab and treat the same types of EGFR-mutated NSCLC, but they are given in different ways:

• Rybrevant is given as an intravenous infusion, which can take several hours, especially for the first doses.
• Rybrevant Faspro combines amivantamab with hyaluronidase and is injected under the skin of the abdomen over about 5 minutes. In studies, the subcutaneous form was associated with a lower rate of administration-related reactions than the IV infusion.

Because the two forms are dosed and given differently, they are not interchangeable. Your care team will decide which form is right for you.

In EGFR-mutated lung cancer, changes in the EGFR and MET proteins on the surface of cancer cells send constant signals that drive the cells to grow and multiply. Amivantamab is a bispecific antibody that attaches to both EGFR and MET at the same time, blocking these growth signals. It also flags the cancer cells it binds so the immune system can help destroy them, a process called antibody-dependent cellular cytotoxicity.

Rybrevant has been studied in several clinical trials in EGFR-mutated NSCLC. Key results include:

• MARIPOSA (first-line, exon 19 deletion or L858R): Rybrevant plus lazertinib was compared with osimertinib. People on Rybrevant went longer before their cancer worsened (median 23.7 vs 16.6 months) and had a higher response rate (78% vs 73%), with responses lasting longer (25.8 vs 16.7 months).
• PAPILLON (first-line, exon 20 insertion): Rybrevant plus chemotherapy was compared with chemotherapy alone. Cancer progression was delayed longer with Rybrevant (median 11.4 vs 6.7 months), and more people responded (67% vs 36%).
• MARIPOSA-2 (previously treated, exon 19 or L858R): Rybrevant plus chemotherapy delayed cancer worsening compared with chemotherapy alone (median 6.3 vs 4.2 months), with a higher response rate (53% vs 29%).
• CHRYSALIS (previously treated exon 20 insertion, Rybrevant alone): about 4 in 10 people had their tumors shrink, with responses lasting a median of 11.1 months.

How well Rybrevant works depends on the specific EGFR mutation, prior treatments, and individual factors. Your cancer care team can explain what these results mean for you.

Rybrevant is given as an intravenous infusion by a healthcare provider. The dose is based on your body weight, and your care team decides how often you receive it and for how long. Your provider will:

• Give medicines before each dose to lower the risk of infusion-related reactions. You may be instructed to take a steroid medicine 48 hours before your first infusion.
• May give additional medicines to reduce skin and nail reactions.
• Split the first dose over 2 days (Day 1 and Day 2) to reduce the risk of reactions.

Rybrevant may be given with carboplatin and pemetrexed, or with lazertinib. If you take lazertinib, swallow your lazertinib dose by mouth any time before your Rybrevant infusion.

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

• Have a history of lung or breathing problems
• Have a history of blood clots
• Have eye problems
• Are pregnant or plan to become pregnant
• Are breastfeeding or plan to breastfeed.

Rybrevant has no contraindications in its FDA label. Rybrevant Faspro should not be used by people with a known allergy to hyaluronidase or any of its ingredients.

Pregnancy

Rybrevant can harm an unborn baby. If you can become pregnant, your provider may do a pregnancy test before you start. Use effective birth control during treatment and for 3 months after your last dose, and tell your provider right away if you become pregnant.

Breastfeeding

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

Common side effects

The most common side effects (reported in 20% or more of people) depend on which medicines Rybrevant is combined with and may include:

• Rash and dry or itchy skin
• Infected skin around the nails (nail toxicity)
• Reactions during or after the infusion or injection
• Muscle and joint pain
• Mouth sores
• Swelling of the hands, ankles, feet, or face (edema)
• Tiredness
• Nausea, vomiting, diarrhea, or constipation
• Decreased appetite
• Cough or shortness of breath (when used alone)
• Blood clots and bleeding (most often with lazertinib)
• COVID-19 infection
• Changes in certain blood tests (laboratory abnormalities)

Serious side effects and warnings

Get emergency medical help if you have signs of a serious allergic reaction, such as trouble breathing or swelling of your face, lips, or tongue. Rybrevant may cause serious side effects, including:

• Infusion-related reactions. These are common and can be severe, including a life-threatening allergic reaction. Tell your care team right away about shortness of breath, chest discomfort, swelling of the eyes, lips, or tongue, fever, chills, flushing, rash or hives, nausea, dizziness, or fainting during your infusion. (With Rybrevant Faspro, these are called administration-related reactions.)
• Lung problems (interstitial lung disease or pneumonitis). These can be life-threatening. Report any new or worsening shortness of breath, cough, or fever.
• Blood clots. Clots in the legs (deep vein thrombosis) or lungs (pulmonary embolism) are common when Rybrevant is used with lazertinib. Your provider will give a blood thinner for the first 4 months. Report leg swelling or pain, sudden chest pain, or shortness of breath.
• Skin reactions. Severe rash can occur. Your provider may prescribe preventive medicines and instruct you to apply a non-comedogenic (non-pore-clogging) moisturizer to your face and body and wash your hands and feet daily with a chlorhexidine solution. Report blistering, peeling, sores, or painful skin.
• Eye problems. Report eye pain, vision changes, redness, dryness, or light sensitivity, and do not wear contact lenses until your symptoms are checked.

Your provider may pause, reduce, or stop Rybrevant if you have serious side effects. These are not all the possible side effects. You may report side effects to the FDA at 1-800-FDA-1088.

With lazertinib or as a single agent:

• Less than 80 kg: 1,050 mg (weekly for 5 weeks, then every 2 weeks from Week 7)
• 80 kg or more: 1,400 mg (weekly for 5 weeks, then every 2 weeks from Week 7)

With carboplatin and pemetrexed:

• Less than 80 kg: 1,400 mg weekly for 4 weeks, then 1,750 mg every 3 weeks from Week 7
• 80 kg or more: 1,750 mg weekly for 4 weeks, then 2,100 mg every 3 weeks from Week 7

Rybrevant Faspro is dosed and given differently and is not interchangeable with the IV form.

What happens if I miss a dose?

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

What should I avoid while receiving Rybrevant?

Rybrevant can make your skin more sensitive to sunlight. Limit time in the sun during treatment and for 2 months after your last dose, wear protective clothing, and use broad-spectrum UVA/UVB sunscreen.

No formal drug interaction studies have been done with Rybrevant. Even so, tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

Rybrevant is stored and prepared by your healthcare provider. The vials are kept in a refrigerator at 36°F to 46°F (2°C to 8°C) in the original carton to protect them from light. The medicine should not be frozen or shaken.

The cost of Rybrevant depends on your dose, how long you are treated, and your insurance coverage. Because it is given by a healthcare provider, it is often billed through your medical benefit rather than a pharmacy.

The manufacturer offers a patient support program, J&J withMe, which can help eligible patients understand coverage and costs and may offer financial assistance. For current pricing, savings options, and patient assistance details, see Rybrevant prices, coupons, and patient assistance.

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.

Available as a 350 mg/7 mL (50 mg/mL) solution in a single-dose vial for intravenous infusion after dilution.