Clinic Conversation of the Week: How to Talk to Patients About the Zenocutuzumab Approval for NSCLC and Pancreatic Adenocarcinoma
Expert Perspectives · Matthew Hadfield, DO · 2024-12-17
What Is Zenocutuzumab?
Zenocutuzumab is a bispecific that works by blocking two important proteins in a pathway that is important for cancer cell growth and proliferation. One arm of the antibody binds to human epidermal growth factor receptor 2 (HER2), and the other binds to neuregulin 1 (NRG1), preventing its binding from HER3. This mechanism has been named as a “dock and block” approach in which the binding of the first antibody optimally positions the binding of the second antibody.
FDA Approval of Zenocutuzumab
Last week, the Food and Drug Administration approved zenocutuzumab for non–small cell lung cancer (NSCLC) and pancreatic adenocarcinoma (PAC) through their accelerated approval pathway. The indication includes patients with advanced, unresectable, or metastatic NSCLC harboring a NRG1 gene fusion with disease progression on or after prior systemic therapy, or advanced, unresectable, or metastatic PAC harboring a NRG1 gene fusion with disease progression on or after prior systemic therapy.
This represents a remarkable advancement for patients with NSCLC and PAC, where options after first-line therapy are unfortunately limited. So, what exactly should patients know about the approval, and how should they be counseled?
Here’s What I Would Say…
“The important thing for you to know about this approval is that it is another advancement in the field of targeted therapies. It’s important to keep in mind that things like chemotherapy target rapidly dividing cells, and they work in that manner. Targeted therapy is going after specific protein mutations or gene mutations that your cancer may harbor.
Why that’s so important is because drugs like zenocutuzumab are now becoming more and more available, and these targeted therapies rely on having special testing to better characterize your tumor and how it grows. We know that many patients in the United States do not get genomic testing of their tumors, and it really has become a detriment to their care if they’re not advocating for that. Every single day, we have new drug approvals based on precision-guided approaches and having that testing to better delineate what treatment options may and may not be available for your type of tumor is incredibly important.
If you’re a patient who has been diagnosed with one of these diseases, it’s very important to make sure that you get next-generation sequencing (NGS) or whole-exome sequencing testing on your tumor to better characterize it and understand what the results are. There may be treatment options with things that zenocutuzumab that are now becoming approved.”
About Dr. Hadfield
Matthew Hadfield, DO, is a Medical Oncologist at Brown University/Legorreta Cancer Center, with a pending faculty appointment at the Warren Alpert School of Medicine of Brown University. He recently completed his Hematology/Oncology Fellowship at Brown University. Dr. Hadfield’s clinical and research interests are in phase 1 clinical trials and developmental therapeutics, as well as cutaneous malignancies and immunotherapy-related adverse events.