The FDA has approved zanidatamab as a monotherapy for previously treated HER2-positive biliary tract cancer (BTC). The bispecific antibody is the first HER2-targeted treatment with this indication. Zanidatamab binds to HER2 proteins, blocking HER2 signaling and inducing immune responses. The approval was based on a phase 2 trial with a 52% response rate and a 14.9 month duration of response. Common side effects include diarrhea, infusion-related reactions, abdominal pain, and fatigue. Zanidatamab is administered every 2 weeks at 20 mg/kg. Jazz Pharmaceuticals’ application was granted priority review, breakthrough therapy designation, and orphan drug designation. Ongoing trials are testing zanidatamab in combination with standard therapy for other cancers.
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