For years, the location of a tumor dictated the treatment. However, recent breakthroughs have identified NRG1 (Neuregulin 1) fusions—a rare genetic rearrangement that acts as a potent oncogenic driver for lung, pancreatic, and bile duct cancers. These fusions are notoriously resistant to standard chemotherapy.
Zenocutuzumab (brand name Bizengri) 
represents a significant leap in targeted therapy. As a bispecific antibody, it is specifically engineered to neutralize the signaling pathways activated by NRG1 fusions.
Following its December 2024 FDA approval for non-small cell lung cancer and pancreatic adenocarcinoma, Zenocutuzumab has now been approved for advanced/metastatic NRG1 fusion-positive cholangiocarcinoma. This marks the first systemic therapy ever available for this rare molecular subset.
The success of Zenocutuzumab signals a new era for patients with rare genetic mutations, proving that when we stop treating the ‘location’ and start treating the ‘mutation,’ we can unlock possibilities for even the most treatment-resistant cancers.
Do you think genetic testing could be a game changer in treating rare, resistant cancers?
MBH/PS