Clinical Significance of ADC in Breast Cancer: Updates Presented at ESMO 2025

In this opening section, the experts review the antibody drug conjugate findings presented at ESMO 2025 and describe how they inform current treatment for patients with breast cancer. Dr Tarantino outlines the major studies featured at the meeting and explains that this year brought an unusual concentration of influential ADC results. He emphasizes the breadth of new data for HER2 positive disease, HER2 low disease, and triple negative disease, and frames the discussion around the expanding role of ADCs across both early and metastatic settings.

The discussion moves to the question of which findings carry the strongest impact for practice. Dr Mouabbi identifies the early stage results from DESTINY Breast 05 and DESTINY Breast 11 as the most influential. Both studies demonstrated substantial activity for trastuzumab deruxtecan in curative intent populations, showing improvement in pathologic response and reduction in recurrence risk. He notes that it is uncommon for several practice changing ADC trials to emerge simultaneously from a single meeting, which adds significance to the overall data set.

The speakers then explain how ADCs differ from targeted therapies and classic chemotherapy. They highlight how linker chemistry, drug to antibody ratio, and payload characteristics influence treatment outcomes and toxicity. Interstitial lung disease, cardiotoxicity, and gastrointestinal symptoms are reviewed as clinically important considerations when selecting therapy for early stage disease. These findings help frame how clinicians can integrate ADCs into discussions with patients and how supportive care planning should be approached.

The section concludes by noting that ADCs now influence treatment across a wide portion of breast oncology. The speakers encourage clinicians to keep pace with ongoing trial readouts, understand toxicity profiles, and prepare for broader use of ADCs in early and metastatic disease. They emphasize the importance of interpreting emerging evidence within the context of individual patient needs and treatment goals.