Trial reportJournal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer2025
Enhanced Versus Standard Dermatologic Management With Amivantamab-Lazertinib in EGFR-Mutated Advanced NSCLC: The COCOON Global Randomized Controlled Trial.
Trial report in Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 31 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Phase 2, Open-Label, Randomized Trial Evaluating the Impact of Enhanced Versus Standard Dermatologic Management on Selected Dermatologic Adverse Events Among Patients With Locally Advanced or Metastatic EGFR-Mutated NSCLC Treated First-Line With Amivantamab + Lazertinib
AmiCARE: A Clinical Trial on the Outcomes of Comprehensive Enhanced Prophylaxis Management (CEPM) in Chinese Patients With EGFR-Mutated Advanced NSCLC Receiving Amivantamab-Based Regimens
Who cites it
31 citing papers in PubMed.
- Phase 2 Study of Amivantamab Plus Lazertinib in Previously Treated Patients With EGFR-Mutant Lung Cancers With Brain and Leptomeningeal Metastases.Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer · 2026Trial
- Lung Cancer Survivorship: Challenges and Care Needs.Cancers · 2026Review
- Article
- Subcutaneous Amivantamab and Lazertinib in PALOMA-3: Efficacy, Safety, and Administration: A Vodcast.Targeted oncology · 2026Article
- Risk-adapted first-line therapy selection in advanced EGFR-mutant NSCLC: a practical clinical algorithm integrating tumor biology and patient factors.Medical oncology (Northwood, London, England) · 2026Review
- Dermatologic adverse events associated with amivantamab: A multicentre study.Journal of the European Academy of Dermatology and Venereology : JEADV · 2026Article
- Cutaneous Toxicities Associated With Amivantamab in Patients With Non-Small Cell Lung Cancer: A Systematic Review.International journal of dermatology · 2026Article
- Scalp and genital ulcerations as cutaneous toxicities of amivantamab and lazertinib combination therapy.JAAD case reports · 2026Article
- Strengthening the EGFR blockade for those lung cancers that need it most.Translational lung cancer research · 2026Article
- Beyond rash management with amivantamab-lazertinib forJournal of thoracic disease · 2026Article
- Targeting ClassicalCancers · 2026Review
- New Treatment Strategies for Rare Genomic Alterations:Cancers · 2026Review
- Risk Stratification and Strategies Towards Front-Line Therapy of EGFR-Mutant NSCLC: A Narrative Review.Cancers · 2026Review
- Review
- Diagnosis and treatment of cutaneous adverse effects of targeted therapy, antibody-drug conjugates, and immunotherapy in cancer patients: a national consensus statement by the Spanish Society of Medical Oncology and the Spanish Academy of Dermatology and Venereology.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Review
- Improving dermatological adverse events from amivantamab plus lazertinib: lessons from the COCOON trial.Journal of thoracic disease · 2026Article
- Enabling precision therapy through dermatologic prophylaxis: lessons from COCOON.Journal of thoracic disease · 2026Article
- The COCOON trial: wrapping potent EGFR therapy in proactive supportive care.Journal of thoracic disease · 2026Article
- Preventive and Therapeutic Interventions for Anticancer Drug-induced Dermatologic Toxicities: a Scoping Review.Current oncology reports · 2026Article
- Survival, toxicity, and sequencing: navigating the new first-line standard established by FLAURA2.Translational lung cancer research · 2026Article
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Authors and funding
36 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAmivantamab plus lazertinib significantly improved progression-free and overall survival versus osimertinib in patients with previously untreated, EGFR-mutant advanced NSCLC. EGFR-targeted therapies are associated with dermatologic adverse events (AEs), which can affect quality of life (QoL). COCOON was conducted to assess prophylactic management and improve treatment experience.
methodsIn the phase 2 COCOON study (NCT06120140), participants with previously untreated, EGFR-mutant, locally advanced or metastatic NSCLC received intravenous amivantamab plus oral lazertinib and were randomized 1:1 to enhanced dermatologic management (COCOON DM) or standard of care (SoC DM) per local guidelines. COCOON DM included oral doxycycline or minocycline (100 mg twice daily; weeks 1-12), clindamycin 1% (on scalp daily; weeks 13-52), chlorhexidine 4% (on fingernails and toenails daily), and ceramide-based moisturizer (on body and face at least daily). Primary end point was incidence of grade 2 or higher dermatologic AEs of interest (DAEIs) by week 12.
resultsIn total, 201 participants were randomized (99 to COCOON DM and 102 to SoC DM). At a median follow-up of 7.1 months, COCOON DM demonstrated significant reduction in the primary end point versus SoC DM (42% versus 75%; OR, 0.24; 95% confidence interval, 0.13-0.45; p < 0.0001). By week 12, the largest benefit with COCOON DM was observed in DAEIs involving the face and body (excludes paronychia; 26% versus 60%; p < 0.0001) and DAEIs involving the scalp (10% versus 26%; p = 0.0049). This benefit was maintained at 6 months, with significant reductions of DAEIs involving face, body, and scalp (excluding paronychia). Patient-reported outcomes favored COCOON DM, indicating reduced impact of dermatologic symptoms on QoL.
conclusionAn uncomplicated, widely available, prophylactic regimen (COCOON DM) reduced the incidence of DAEIs with amivantamab-lazertinib and the impact of symptoms on QoL.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.