pairingsPairing
EGFR TKI → ADC on progression
After the lung cancer pill stops working, an ADC that does not care which resistance mutation emerged.
Dato-DXd approved (2025) after osimertinib and chemotherapy in EGFR-mutant NSCLC; HER3-DXd and iza-bren target the same setting. Amivantamab + chemotherapy (MARIPOSA-2) is the alternative.
Rationale
Resistance to TKIs is heterogeneous (C797S, MET, transformation); ADCs bypass genotype by exploiting antigen expression.
Evidence
Approval; phase 3 data.