An evaluation of becotatug vedotin for the treatment of recurrent or metastatic nasopharyngeal cancer.

INTRODUCTION: Recurrent or metastatic nasopharyngeal carcinoma (R/M NPC) remains a significant clinical challenge despite advances in chemoradiation, with approximately 30% of patients ultimately developing R/M disease. There is an ongoing unmet need for novel therapeutic approaches that improve outcomes in this population. Becotatug vedotin (MRG003) is an antibody-drug conjugate (ADC) that couples an anti‑epidermal growth factor receptor (EGFR) monoclonal antibody to the microtubule‑disrupting payload monomethyl auristatin E (MMAE). Early clinical experience has suggested antitumor activity of becotatug vedotin in R/M NPC. AREAS COVERED: This review summarize available clinical data on becotatug vedotin, with emphasis on the pivotal studies that have informed its clinical approved. Key trials include the Phase I MRG003‑001 study and the Phase II a/b MRG003‑005 study, which collectively provide the principal evidence base for efficacy and safety in NPC. Trial designs, patient populations, efficacy endpoints, and safety profiles are summarized and compared with outcomes reported for other EGFR‑targeting ADCs to contextualize becotatug vedotin's therapeutic application and limitations. EXPERT OPINION: Becotatug vedotin demonstrates promising antitumor activity in R/M NPC and represents a potentially valuable addition to the therapeutic drug. Future investigations should define the most effective dosing regimens and explore rational combination approaches, including integration into front-line.