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Zenocutuzumab + afatinib is an investigational combination therapy comprised of zenocutuzumab, a bispecific IgG1 monoclonal antibody targeting HER2 and HER3, and afatinib, a small molecule irreversible inhibitor of EGFR and HER2 signals, both administered to treat advanced solid tumors with neuregulin 1 (NRG1) gene fusions. Zenocutuzumab blocks the dimerization of HER2:HER3 and prevents NRG1 binding to HER3, thereby inhibiting downstream PI3K-AKT-mTOR cell signaling and mediating antibody-dependent cellular cytotoxicity (ADCC)[1][4][6]. Afatinib simultaneously inhibits EGFR (ErbB1) and HER2 (ErbB2) signaling, providing complementary inhibition of the ErbB receptor family. Combined, the therapy aims to overcome resistance mechanisms and improve efficacy for tumors driven by NRG1 gene fusions. Clinical studies are investigating the combination in NRG1-positive, advanced non-small cell lung cancer (NSCLC) and other solid tumors[7].
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