Physician Developed New Cancer Drug Protocol
A new subcutaneous administration protocol streamlines treatment for dual EGFR blockade patients.
Updated on Oct. 6, 2026 in Cancer
Dr. Edgardo Santos has established a new subcutaneous protocol for the administration of amivantamab plus lazertinib. This method replaces lengthy intravenous infusions with a 5-minute injection process.
Why it matters
The new protocol addresses clinical challenges related to venous thromboembolism and skin toxicities that frequently arise during dual EGFR blockade therapy. By standardizing patient care, the approach seeks to manage common side effects more effectively.
The new administration process requires a 5-minute subcutaneous injection. The regimen includes prophylactic oral anticoagulation for 4 months and antibiotic skin toxicity treatment for 12 weeks.
The players
Edgardo Santos
Edgardo Santos is a physician at Starling Oncology who developed this new administrative protocol.
The details
The protocol utilizes the COCOON skin toxicity management regimen, which includes 100 mg of oral doxycycline or minocycline twice daily. Patients also use ceramide-based moisturizers and 4% chlorhexidine nail soaks to prevent paronychia, transitioning to a scalp lotion after the 12th week.
Timeline
Week 1: Dexamethasone is administered alongside the start of antibiotic treatment.
First 4 months: Duration of prophylactic-dose oral anticoagulation.
Week 1 through Week 12: Course of oral doxycycline or minocycline treatment.
Week 13 onward: Implementation of scalp lotion application.
The Big Picture
This protocol marks a departure from the intravenous dosing procedures established by the MARIPOSA trial. By transitioning to subcutaneous administration, the development reflects a broader shift toward reducing the clinical burden on cancer patients.
The transition to a 5-minute injection replaces the previously required 2-day intravenous infusion process. Patients following this protocol must adhere to specific daily routines for skin and nail maintenance to mitigate treatment-related toxicities.
The takeaway
Switching to subcutaneous delivery significantly reduces the time patients spend receiving treatment in a clinical setting. Careful adherence to the prophylactic skin and anti-clotting regimens remains essential for managing side effects safely.
Further reading
For more information on clinical advancements, visit the Cancer section.
Source note: This article includes information reported by OncLive.
