Addressing Sequencing Questions With TROP-2–Directed ADCs in TNBC

The emergence of multiple TROP-2–directed ADCs raises critical questions about sequencing and cross-resistance in TNBC. Panelists discuss how to integrate agents like sacituzumab govitecan and datopotamab deruxtecan (Dato-DXd) within the treatment algorithm. They explore mechanisms of resistance, overlapping toxicities, and the potential benefits of alternating ADCs based on payload or linker technology. Sequencing decisions may depend on prior drug exposure, biomarker evolution, and patient tolerance. The discussion highlights that clinical data on sequential ADC use remain limited, emphasizing the need for ongoing studies to guide real-world decisions.