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WCLC 2026 | How will izalontamab brenitecan fit in the lung cancer treatment landscape?

Alexander Spira, MD, PhD, FACP, FASCO, Virginia Cancer Specialists and US Oncology, Fairfax, VA, comments on the complexities of treatment options in EGFR-mutated non-small cell lung cancer (NSCLC), highlighting the various choices available in first and second line settings, including izalontamab brenitecan (iza-bren). The emergence of new drugs targeting the C797S resistance mutation will also add to the existing array of options such as chemo-based treatments, amivantamab, and lazertinib. Having multiple options, including iza-bren, which appears to have a favorable side effect profile with no mucositis, will be beneficial for patients in this setting. This interview took place at the IASLC 2026 World Conference on Lung Cancer congress in Seoul, Republic of Korea.

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Transcript

So where iza-bren falls in is, in fact, very complicated because right now there’s multiple options in first line. We have FLAURA 2, which is chemo, osi, amivantimab, lazertinib, MARIPOSA, as well as regular old osi, which a lot of people are still using because it’s very well tolerated and easy. In the second line, it does get more complicated first based upon that, as well as the multitude of options...

So where iza-bren falls in is, in fact, very complicated because right now there’s multiple options in first line. We have FLAURA 2, which is chemo, osi, amivantimab, lazertinib, MARIPOSA, as well as regular old osi, which a lot of people are still using because it’s very well tolerated and easy. In the second line, it does get more complicated first based upon that, as well as the multitude of options. We have data coming out with iza-bren, we have chemo-based options, we have datapodumab, and of course we have iza-bren. So it does make it very complicated. We’re also looking at new drugs coming down the pike that target C797S, which is a resistance mutation most commonly seen after Osi-only therapy. So it does get to be very complicated and a lot of players in the field. So where does this fall in? It’ll be a great tool to have in our armamentarium. There’s no mucositis, so in that way it appears to be better than datapodamab, but lots of options for our patients, which is always great.

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