Howard A. “Skip” Burris, III, MD, FASCO, FACP, chief medical officer, president, Clinical Operations, Sarah Cannon Research Institute, and a 2014 Giant of Cancer Care® in Drug Development, discusses the integration of sacituzumab govitecan-hziy (Trodelvy) into the treatment landscape of metastatic triple-negative breast cancer (TNBC).

Antibody-drug conjugates (ADCs), such as sacituzumab govitecan, which targets the TROP-2 receptor and harbors a cytotoxic payload linked to SN-38, have demonstrated significant efficacy in patients with metastatic TNBC, Burris says. The FDA granted an accelerated approval to the ADC in April 2020 based on data from a phase 1/2 trial (NCT01631552) of sacituzumab govitecan in patients with metastatic TNBC. In April 2021, the FDA granted a regular approval to the agent based on confirmatory data from the randomized phase 3 ASCENT trial (NCT02574455), where sacituzumab govitecan outperformed physician’s choice of single-agent treatments in this patient population, Burris explains.

Moreover, the National Comprehensive Cancer Network guidelines include sacituzumab govitecan as a recommended treatment for patients with metastatic TNBC who have received 2 or more prior systemic therapies, at least 1 of them for metastatic disease, Burris adds. Overall, the ADC is quickly becoming a standard of care option early in the treatment of patients with metastatic TNBC, Burris concludes.

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Howard A. “Skip” Burris, III, MD, FASCO, FACP, discusses the integration of sacituzumab govitecan-hziy into the treatment landscape of metastatic triple-negative breast cancer. 


Dr. Burris on the Integration of Sacituzumab Govitecan in Metastatic TNBC 

Howard A. “Skip” Burris, III, MD, FASCO, FACP, chief medical officer and president of Clinical Operations at Sarah Cannon Research Institute, and a 2014 Giant of Cancer Care® in Drug Development, discusses recent advancements made in the field of triple-negative breast cancer (TNBC).

In the field of TNBC, significant advances have been made; they focus on 3 paradigms that have become attractive for the treatment of patients with cancer, according to Burris: immunotherapy, targeted biologics, and antibody-drug conjugates (ADCs).

In terms of targeted biologics, PARP inhibitors target specific mutational profiles. Additionally, ADCs were designed to deliver chemotherapy via an antibody, otherwise known as the “smart bomb” approach; this entails targeting the tumor, minimizing collateral damage, and more effectively delivering a toxin to the cells to achieve cell death, explains Burris. Now, sacituzumab govitecan (Trodelvy) has become the first FDA-approved ADC for use in patients with TNBC; this agent has generated excitement and holds a lot of promise, according to Burris.

Many patients with early-stage TNBC would benefit from neoadjuvant therapy as the majority will not receive hormonal therapy or HER2-based therapy; they are candidates for chemotherapy. Evaluating different neoadjuvant and adjuvant strategies remains the focus of several clinical trial efforts, says Burris. With regard to neoadjuvant therapy, the addition of checkpoint inhibitors—specifically immunotherapy with chemotherapy—have generated promising results.

Specifically, the addition of pembrolizumab (Keytruda) is being explored in this setting and this approach has resulted in deep responses, notes Burris. Pathological complete response, in particular, is the current standard. However, longer follow-up is needed to examine the overall benefits of this approach and whether these patients might require further treatment, concludes Burris.

Howard A. “Skip” Burris, III, MD, FASCO, FACP, discusses recent advancements made in the field of triple-negative breast cancer.

Dr. Burris on Recent Advances in TNBC

Howard “Skip” A. Burris, III, MD, chief medical officer, Sarah Cannon Research Institute, and a 2014 Giant of Cancer Care

 in Drug Development, discusses the potential of PARP inhibitors in patients with with triple-negative breast cancer (TNBC).

Oral PARP inhibitors taken once a day are being used to treat patients with TNBC, particularly those with 

 mutations, such as inherited germline mutations or somatic mutations.

Some early results in the treatment of patients with ovarian cancer have been positive, says Burris, with PARP inhibitors approved in the maintenance setting and in later settings of ovarian cancer.

TNBC clinical trial results have been positive, as this subgroup's molecular genotype makes them sensitive to PARP inhibitors. However, more research needs to be done on how to give these inhibitors in neoadjuvant or later-line settings, says Burris.

Howard “Skip” A. Burris, III, MD, chief medical officer, Sarah Cannon Research Institute, and a 2014 Giant of Cancer Care® in Drug Development, discusses the potential of PARP inhibitors in patients with triple negative breast cancer (TNBC).

Howard A. Burris, III, MD

Articles

Dr. Burris on the Integration of Sacituzumab Govitecan in Metastatic TNBC

Dr. Burris on Recent Advances in TNBC

Dr. Burris on the Potential of PARP Inhibitors in TNBC