Seoul – September 16, 2026 -- Johnson & Johnson reported that its RYBREVANT (amivantamab-vmjw) plus chemotherapy combination extended median overall survival to 34.3 months in patients with EGFR exon 20 insertion-mutated advanced non-small cell lung cancer, compared with 27.9 months for chemotherapy alone, according to final data from the Phase 3 PAPILLON study.
Combination therapy nearly doubles historical survival benchmarks
The result marks the longest reported median overall survival for this patient population, which has historically faced a five-year survival rate of just 8 percent and a median overall survival ranging from 16 to 24 months. EGFR exon 20 insertion mutations account for approximately 12 percent of all EGFR mutations and have proven difficult to treat with existing targeted therapies.
Crossover-adjusted analysis shows 43 percent reduction in death risk
The topline hazard ratio for overall survival was 0.87 (95% CI, 0.66-1.14; P=0.307), a result affected by 76 percent of eligible chemotherapy-arm patients crossing over to second-line RYBREVANT after disease progression. A prespecified analysis correcting for this crossover showed a statistically significant benefit, with RYBREVANT plus chemotherapy reducing the risk of death by 43 percent (HR, 0.57; 95% CI, 0.39-0.82; nominal P=0.003).
Progression-free survival through second relapse extended by over 10 months
The combination extended progression-free survival through second disease progression (PFS2) to 28.3 months versus 17.5 months for chemotherapy alone (HR, 0.59; 95% CI, 0.45-0.77; nominal P0.0001). At the clinical cutoff, 12 percent of patients remained on first-line RYBREVANT treatment, compared with none in the chemotherapy-only arm. Patient-reported outcomes also favored the combination, delaying the worsening of key lung cancer symptoms.
Safety profile remains consistent, with adverse events in over half of patients
Treatment-related adverse events occurring in at least 30 percent of patients included paronychia (60 percent), neutropenia (60 percent) and rash (58 percent). No new safety signals emerged with longer follow-up, and the profile matched earlier reports predating prophylactic management strategies.
Data presented at IASLC's 2026 World Conference on Lung Cancer
The findings were unveiled during the Presidential Symposium at the International Association for the Study of Lung Cancer 2026 World Conference on Lung Cancer (Late-breaking Abstract #PL.03.03). The PAPILLON study enrolled 308 patients in a randomized, open-label design comparing RYBREVANT plus carboplatin-pemetrexed chemotherapy against chemotherapy alone as first-line treatment.
Dr. Chul Kim of MedStar Georgetown University Hospital said patients are continuing treatment years after starting therapy, calling it evidence of durability for the first-line regimen. Johnson & Johnson's Yusri Elsayed said the results establish the regimen as a backbone therapy across common, atypical and exon 20 insertion EGFR mutation types.
Additional data presented at the conference covered prophylactic strategies from the COPERNICUS study aimed at reducing treatment-related events, and subcutaneous administration results from the PALOMA-2 study evaluating RYBREVANT FASPRO.