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A first-in-class drug is shaking up lung cancer treatment. Izalontamab brengitecan (iza-bren), a bispecific antibody-drug conjugate targeting EGFR and HER3, nearly doubled progression-free survival compared to standard chemotherapy in patients with EGFR-mutated advanced non-small cell lung cancer who progressed on third-generation TKIs. The phase 3 PANKU-Lung01 results, published in The Lancet, position iza-bren as a promising new option in a setting with limited alternatives.
A first-in-class bispecific antibody-drug conjugate (ADC) is making waves in lung cancer care. In the phase 3 PANKU-Lung01 trial, izalontamab brengitecan (iza-bren) — which targets both EGFR and HER3 — delivered a median progression-free survival (PFS) of 11.1 months versus just 5.7 months with platinum-based chemotherapy in patients with EGFR-mutated advanced non-squamous NSCLC who had progressed on third-generation EGFR TKIs. Results were presented at the 2026 ESMO Congress and simultaneously published in The Lancet.
The benefit was consistent across all prespecified subgroups, and the confirmed objective response rate was nearly double that of chemotherapy. While overall survival data remain immature, early trends favor iza-bren. The drug already holds FDA Breakthrough Therapy Designation for this indication, and global registration trials are underway in both the post-TKI and first-line settings.
By the Numbers:
Why it matters: Most patients with EGFR-mutated NSCLC eventually develop resistance to TKIs, leaving platinum-based chemotherapy as the standard next step — an option with modest outcomes. Iza-bren's dramatic PFS improvement could redefine the post-TKI treatment landscape, offering a more effective alternative for a large and growing patient population.
