If you have lung cancer that is advanced or has spread, your doctor may prescribe Rybrevant for you. It’s a prescription drug used in adults to treat non-small cell lung cancer (NSCLC) that:
- has spread to other parts of the body or cannot be removed by surgery
- has abnormal gene mutations in a specific receptor (a kind of protein) on cancer cells
- has worsened during or after chemotherapy with platinum
To learn more about NSCLC and how Rybrevant is used, see “What is Rybrevant used for?” below.
Rybrevant basics
Rybrevant contains the active ingredient amivantamab-vmjw.* (An active ingredient is what makes a drug work.) It comes as a solution that your doctor will mix with another liquid. They’ll then give you the drug as an intravenous (IV) infusion (an injection into a vein given over time).
Rybrevant is a biologic drug, which means it’s made from parts of living cells. It’s not available in a biosimilar form. (Biosimilars are like generic drugs. But unlike generics, which are made for non-biologic drugs, biosimilars are made for biologic drugs.) Instead, amivantamab-vmjw comes only as the brand-name drug Rybrevant, which is a targeted therapy.
In this article, we describe Rybrevant’s uses, cost, side effects, and more.
* The “-vmjw” appears at the end of the drug’s name to show that the drug is distinct from similar medications that may be created in the future.
Rybrevant is used in adults to treat non-small cell lung cancer (NSCLC) that:
- has spread to other parts of the body or cannot be removed by surgery
- has abnormal gene mutations in a specific receptor (a kind of protein) on cancer cells
- has worsened during or after chemotherapy with platinum
Rybrevant is an antibody drug. It works by targeting two mutated receptors (a kind of protein) located on cancer cells. These mutated receptors are known as:
- epidermal growth factor receptors (EGFR)
- hepatocyte growth factor receptors (called MET)
When Rybrevant attaches to EGFR and MET, it disrupts the pathways cells use to communicate. It also triggers an immune response that attacks cancer cells.
Note: For the circumstances outlined above, Rybrevant received
Prices for prescription drugs can vary depending on many factors, such as what your insurance plan covers and which pharmacy you use.
If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You may also be eligible for a support program called Janssen Compass. This program can help you find ways to cover or lower the cost of Rybrevant.
You can also check out this article to learn more about saving money on prescriptions.
Like most drugs, Rybrevant may cause mild to serious side effects. The lists below describe some of the more common side effects this drug may cause. But they don’t include all possible side effects.
Keep in mind that side effects of a drug can depend on:
- your age
- other health conditions you have
- other medications you take
Your doctor or pharmacist can tell you more about the potential side effects of Rybrevant and suggest ways to help reduce them.
Mild side effects
Below are some of the mild side effects that Rybrevant can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Rybrevant’s prescribing information.
Mild side effects of Rybrevant that have been reported include:
- rash
- itchiness
- dry skin
- mild infusion-related reaction
- muscle, joint, and bone pain
- nausea
- vomiting
- fatigue (low energy)
- swelling in the legs, feet, and hands
- fever
- cough
- infection
- constipation
- diarrhea
- belly pain
- inflammation in the mouth
- low appetite
- nerve pain
- dizziness
- headache
- mild allergic reaction*
Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.
* To learn more about this side effect, see the “Allergic reaction” section below.
Serious side effects
Serious side effects from Rybrevant can occur, but they aren’t common. If you have serious side effects from Rybrevant, call your doctor right away. But if you think you’re having a medical emergency, you should call 911 or your local emergency number.
Serious side effects of Rybrevant that have been reported include:
- eye-related side effects, including:
- changes in vision, such as blurry vision or vision loss
- pain in your eye
- dry eye
- inflammation in your eye
- severe infusion-related reaction
- interstitial lung disease and pneumonitis (lung inflammation)
- severe skin reactions, including a rare but life threatening condition called toxic epidermal necrolysis (TEN)
- severe allergic reaction*
* To learn more about this side effect, see the “Allergic reaction” section below.
Allergic reactionSome people may have an allergic reaction to Rybrevant. While allergic reaction wasn’t reported in studies of Rybrevant, it can still happen. Symptoms of a mild allergic reaction can include:
A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, usually in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.
Call your doctor right away if you have an allergic reaction to Rybrevant. But if you think you’re having a medical emergency, immediately call 911 or your local emergency number.
Find answers to some commonly asked questions about Rybrevant.
What is Rybrevant’s mechanism of action?
Rybrevant’s mechanism of action (how it works) is that it binds to two mutated receptors (a kind of protein) located on cancer cells. These mutated receptors are known as:
- epidermal growth factor receptors (EGFR)
- hepatocyte growth factor receptors (called MET)
By binding to these receptors, Rybrevant affects certain functions inside the cancer cell. When Rybrevant activates the EGFR and MET, it targets the cells to be destroyed by the immune system.
How does Rybrevant compare with Tagrisso for treating non-small cell lung cancer?
Tagrisso contains the active drug osimertinib, while Rybrevant contains the antibody amivantamab-vmjw.
Tagrisso is a prescription drug used to treat non-small cell lung cancer (NSCLC) with specific gene mutations in adults:
- after tumor removal by surgery, or
- with metastases, or
- with worsened cancer during or after certain other treatments
Rybrevant is used in adults to treat NSCLC that:
- can’t be removed by surgery or has spread to other parts of your body
- has specific gene mutations in receptors (a kind of protein) on the cancer cells
- has worsened while on or after receiving chemotherapy with platinum
Tagrisso also works differently than Rybrevant to treat NSCLC. It targets a different part of the mutated epidermal growth factor receptor (EGFR) than Rybrevant.
Is Rybrevant a kind of immunotherapy or chemotherapy?
No, Rybrevant is a kind of targeted therapy, which means the drug targets specific cells in order to treat cancer. These targeted cells are responsible for helping cancer cells grow and spread.
Immunotherapy drugs target cancer by changing how your immune system works. These drugs may also target specific cells.
Chemotherapy is another kind of cancer treatment that doctors may prescribe to treat NSCLC. It involves killing cancer cells or stopping them from multiplying. It doesn’t target specific cells like immunotherapy or targeted therapies.
Your doctor will recommend the dosage of Rybrevant that’s right for you. Below are commonly used dosages, but the dosage you receive will be determined by your doctor.
Form
Rybrevant comes as a solution that your doctor will mix with another fluid. They’ll then give you the drug as an intravenous (IV) infusion (an injection into a vein given over time).
Recommended dosages
Your doctor will calculate your dosage of Rybrevant based on your body weight. You’ll receive your IV infusion once per week for 4 weeks. Your first infusion will be split over 2 days. After your fourth dose, you’ll receive an IV infusion every other week.
Questions about Rybrevant’s dosing
Below are some common questions about Rybrevant’s dosing.
- What if I miss a dose of Rybrevant? If you miss an appointment for your Rybrevant infusion, call your doctor immediately to reschedule. Missing doses of this drug may make the treatment less effective in treating your lung cancer.
- Will I need to use Rybrevant long term? Depending on how you respond to treatment with Rybrevant, you may need to use it long term. Your doctor will continue prescribing Rybrevant until your disease progresses or you have bothersome side effects. To find out how long you’ll need to use Rybrevant, talk with your doctor.
- How long does Rybrevant take to work? Rybrevant starts to work quickly, but it might take a few months before your doctor notices its effects. Your doctor may order certain medical tests, such as blood tests and lung scans, to check that the drug is working.
Your doctor will explain how Rybrevant will be given to you. They’ll also explain how much you’ll be given and how often.
Receiving Rybrevant
Rybrevant comes as a solution that your doctor will mix with another fluid. They’ll then give you the drug as an intravenous (IV) infusion (an injection into a vein given over time).
Using Rybrevant with other drugs
You’ll need to take other medications with Rybrevant to help control side effects. You’ll receive the following drugs 15 to 60 minutes before each infusion:
- an antihistamine such as diphenhydramine (Benadryl)
- an antipyretic drug such as acetaminophen (Tylenol)
These drugs can be given by mouth or intravenous injection (an injection into a vein).
For your first dose of Rybrevant, your doctor will also inject a glucocorticoid such as dexamethasone or methylprednisolone 45 to 60 minutes before Rybrevant. You may also need to receive a glucocorticoid injection before other doses of Rybrevant, depending on any side effects you may experience with your first dose.
Questions for your doctorYou may have questions about Rybrevant and your treatment plan. It’s important to discuss all your concerns with your doctor. Here are a few tips that might help guide your discussion:
- Before your appointment, write down questions such as:
- How will Rybrevant affect my body, mood, or lifestyle?
- Bring someone with you to your appointment if doing so will help you feel more comfortable.
- If you don’t understand something related to your condition or treatment, ask your doctor to explain it to you.
Remember, your doctor and other healthcare professionals are available to help you. And they want you to get the best care possible. So don’t be afraid to ask questions or offer feedback on your treatment.
Some important things to discuss with your doctor when considering treatment with Rybrevant include your overall health and any medical conditions you may have.
Tell your doctor if you’re taking any other medications. This is important because some drugs can interfere with Rybrevant. These and other considerations to discuss with your doctor are described below.
Interactions
Taking a medication with certain vaccines, foods, and other things can affect how the medication works. These effects are called interactions.
Before starting Rybrevant, be sure to tell your doctor about all medications you take, including prescription and over-the-counter kinds. Also describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with Rybrevant.
For information about drug-condition interactions, see the “Warnings” section below.
Interactions with drugs or supplements
There currently aren’t any medications or supplements known to interact with Rybrevant. But this doesn’t mean drug interactions won’t be recognized in the future. For example, new medications may be approved that interact with Rybrevant.
For this reason, you should still tell your doctor and pharmacist about any medications you take besides Rybrevant. They can then check for any new interactions during your treatment.
Warnings
Rybrevant may not be right for you if you have certain medical conditions. (This is known as a drug-condition interaction.) Other factors may also affect whether this drug is a good treatment option for you. Talk with your doctor about your health history before starting Rybrevant. Below are several factors to consider.
Breathing problems. Rybrevant can worsen interstitial lung disease (ILD) and pneumonitis (lung inflammation). If you have symptoms such as trouble breathing, cough, or fever, your doctor may temporarily stop your Rybrevant treatment. But if they confirm that you have IDL or pneumonitis, they’ll stop your Rybrevant treatment altogether.
Allergic reaction. If you’ve had an allergic reaction to Rybrevant or any of its ingredients, your doctor will likely not prescribe it for you. Ask them about other medications that might be better options.
Decreased lymphocytes. Rybrevant can cause a decrease in a certain kind of white blood cell called lymphocytes. When lymphocyte levels in your blood drop, your risk of getting an infection increases. If you notice symptoms of an infection, such as fever, talk with your doctor.
Sun sensitivity. Rybrevant might make your skin sensitive to the sun. You’ll need to limit your exposure to the sun during treatment with Rybrevant and up to 2 months after your final dose. If you can’t avoid sun exposure, wear clothing and a broad-spectrum ultraviolet A/ultraviolet B (UVA/UVB) sunscreen to protect your skin.
Rybrevant and alcohol
Though some medications interact with alcohol, Rybrevant isn’t one of them. But certain side effects of this drug, such as nausea, vomiting, and headache, may worsen if you drink alcohol.
If you decide to drink alcohol during your treatment, ask your doctor how much, if any, is safe with Rybrevant.
Pregnancy and breastfeeding
Rybrevant isn’t safe to use during pregnancy. There’s no data in humans that evaluates its risk to pregnant people or fetuses. But the mechanism of action of Rybrevant (how it works in the body) suggests that it can cause harm to a fetus.
Tell your doctor if you’re pregnant or planning a pregnancy before starting Rybrevant. Before prescribing this drug for you, they’ll give you a pregnancy test to make sure you’re not pregnant.
If you’re a female* who can get pregnant, your doctor will tell you to use effective contraception. And you’ll need to continue using it for 3 months after your last dose of Rybrevant.
You should not breastfeed during your Rybrevant treatment or for 3 months after your last dose because of possible harm to your child. Talk with your doctor about the best treatment for your condition and feeding option for your child if you are breastfeeding or planning to.
* In this article, we use the term “female” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.
If you have questions about Rybrevant, talk with your doctor or pharmacist. Your doctor can tell you about other treatments you can use for your condition. Some questions you may want to ask your doctor about this drug include:
- Will I lose my hair or nails during Rybrevant treatment?
- Can I drive immediately after receiving a dose of this drug?
- How can I protect my eyes while my condition is being treated with Rybrevant?
- How can I protect my skin while I’m taking Rybrevant?
Here are a few articles you might find helpful:
- How Does Targeted Therapy Treat Lung Cancer?
- Finding the Best Treatment for NSCLC: Why Mutations Matter
- Chemotherapy for Lung Cancer: What to Know
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.