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When EGFR-targeted therapies stop working, options get limited fast — but a new drug is changing that. The phase 3 PANKU-Lung01 trial found that izalontamab brengitecan (iza-bren) nearly doubled progression-free survival compared to platinum-based chemotherapy in EGFR-mutated NSCLC patients after a third-generation EGFR TKI. Results were simultaneously published in The Lancet.
When EGFR-targeted therapies stop working in non-small cell lung cancer (NSCLC), options get limited fast. But a new bispecific antibody-drug conjugate (ADC) called izalontamab brengitecan (iza-bren) is showing real promise for patients in that tough spot. The phase 3 PANKU-Lung01 trial, presented at the 2026 ESMO Congress and published in The Lancet, found that iza-bren nearly doubled median progression-free survival (PFS) compared to standard platinum-based chemotherapy in patients with EGFR-mutated nonsquamous NSCLC who progressed on a third-generation EGFR TKI.
Iza-bren targets both EGFR and HER3, delivering a topoisomerase I inhibitor payload directly to tumor cells. The trial enrolled 432 patients across both arms, with most being younger than 65, never-smokers, and without CNS metastases — a fairly representative real-world population for this setting.
By the Numbers:
Why it matters: For patients who've exhausted third-generation EGFR TKIs, chemotherapy has been the default — with modest results. Iza-bren's dramatic PFS improvement and higher response rates could establish it as a new standard of care in this setting, pending global regulatory review.
