Clinical Context
A typical patient is an adult with metastatic or unresectable non–small cell lung cancer (NSCLC) harboring an EGFR exon 20 insertion mutation who is scheduled to receive intravenous infusion of J9061 (amivantamab-vmjw) in an outpatient oncology infusion clinic or hospital outpatient infusion center. The workflow begins with oncologist evaluation and documentation of molecular testing confirming an EGFR exon 20 insertion. Pre-treatment orders include verification of baseline labs (CBC, CMP), documentation of weight for dose calculation, infusion consent, and allergy history. A pharmacy prepares the J9061 dose in a biologics-safe environment and labels the syringe or bag per institutional policy. Nursing performs pre-infusion vital signs, places an IV access, and administers premedications as ordered (e.g., antihistamine, acetaminophen, corticosteroid) to reduce infusion-related reactions. The infusion is administered per manufacturer and institutional protocols with continuous monitoring for infusion reactions; vital signs are recorded at regular intervals and the patient is observed for a required period after completion. Any acute reactions are managed per protocol and documented. Post-infusion orders include scheduling the next infusion, documenting dose, lot number, and any modifiers applicable to billing, and updating the patient’s electronic health record with infusion time, total milligrams administered (units billed as J9061 per 2 mg), and any adverse events. Typical sites of service are outpatient oncology infusion clinics, hospital outpatient departments, and, when clinically appropriate, physician office-based infusion suites. Patient scenario modifiers that may apply include circumstances such as therapy initiated in observation status, participation in an approved limited distribution program, or partial administration due to an infusion reaction.