Targeted drug outperforms chemotherapy for patients with hard-to-treat lung cancer

by University of Texas MD Anderson Cancer Center

edited by Sadie Harley, reviewed by Andrew Zinin

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The targeted therapy sunvozertinib was more effective than standard platinum-based chemotherapy as a first-line treatment for patients with advanced non-small cell lung cancer (NSCLC) driven by EGFR exon 20 insertion mutations (EGFR exon20ins), according to new research from The University of Texas MD Anderson Cancer Center.

Results from the Phase III WU-KONG28 trial revealed that sunvozertinib significantly extended progression-free survival, or the time patients lived without their disease worsening, to more than 10 months, compared to 7.5 months with chemotherapy alone. The treatment also shrank tumors in 58.9% of patients receiving sunvozertinib, compared with 31.1% on chemotherapy.

The findings were presented at the 2026 American Society of Clinical Oncology (ASCO) Annual Meeting by lead author John Heymach, M.D., Ph.D., chair of Thoracic/Head and Neck Medical Oncology and published concurrently in the New England Journal of Medicine.

"For years, patients with lung cancer harboring EGFR exon 20 insertion mutations have faced poor outcomes because available treatments simply didn't work well, or have substantial toxicities," Heymach said. "These results show that sunvozertinib can control the disease longer and shrink tumors more often than chemotherapy, offering a new, much-needed option for those starting treatment."

What is sunvozertinib and how can it benefit patients?

EGFR exon20ins mutations occur in a small group of patients with NSCLC, and these cancers are especially difficult to treat because they do not respond well to earlier generations of targeted therapies. Sunvozertinib is a next‑generation EGFR inhibitor designed specifically to block the abnormal signaling caused by these exon20ins mutations.

Sunvozertinib is also taken as an oral pill, which can make treatment more convenient for patients and reduce the amount of time needed in the clinic or hospital.

In August 2023, sunvozertinib was granted accelerated approval by the Food and Drug Administration (FDA) for patients with advanced NSCLC with EGFR exon20ins who had previously been treated with platinum-based chemotherapy.

What are other key findings of the WU-KONG28 study?

The international trial enrolled 324 patients who were randomly assigned to receive either sunvozertinib once daily or standard chemotherapy with carboplatin and pemetrexed, followed by pemetrexed maintenance. Patients receiving chemotherapy were allowed to switch to sunvozertinib if their cancer progressed.

Responses lasted a median of 11.2 months with sunvozertinib versus 7.1 months with chemotherapy. Side effects were consistent with earlier studies. Only 7.4% of patients stopped treatment due to drug-related side effects, and no treatment‑related deaths occurred.

Limitations of the study include that the overall survival results aren't detailed yet. Also, because most patients on chemotherapy switched to sunvozertinib once their cancer progressed, it makes long‑term comparisons between the two groups difficult.

Publication details

New England Journal of Medicine (2026). www.nejm.org/doi/full/10.1056/NEJMoa2604461

Abstract LBA8500: Sunvozertinib monotherapy versus platinum-based chemotherapy as first-line treatment for advanced NSCLC with EGFR exon20ins: Primary analysis of a multinational phase 3 randomized study (WU-KONG28). www.asco.org/abstracts-presentations/259326

Journal information: New England Journal of Medicine

Key medical concepts

Carcinoma, Non-Small-Cell LungProgression-Free Survival

Clinical categories

OncologyPulmonary medicineClinical pharmacology Provided by University of Texas MD Anderson Cancer Center Who's behind this story?

Sadie Harley

BSc Life Sciences & Ecology. Microbiology lab background with pharmaceutical news experience in oil, gas, and renewable industries. Full profile →

Andrew Zinin

Master's in physics with research experience. Long-time science news enthusiast. Plays key role in Science X's editorial success. Full profile →

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