Dr Davis on the Utility of ADCs in Breast Cancer

Andrew Davis, MD, assistant professor, medicine, Division of Medical Oncology, Washington University School of Medicine, medical oncologist, Siteman Cancer Center, discusses the use of antibody-drug conjugates (ADCs) in patients with breast cancer, highlighting recent updates with these agents in the treatment paradigm.

Currently, 3 ADCs have been granted FDA approval for patients with breast cancer: ado-trastuzumab emtansine (Kadcyla; T-DM1), fam-trastuzumab deruxtecan-nxki (Enhertu; T-DXd), and sacituzumab govitecan-hziy (Trodelvy), Davis begins. Among them, T-DM1 stands as the pioneering agent, primarily prescribed for patients with advanced or metastatic HER2-positive breast cancer, he states. Additionally, it has been authorized for use as adjuvant therapy in patients with HER2-positive early-stage breast cancer who retain residual disease after neoadjuvant therapy and surgery, Davis explains.

The recent approvals of T-DXd and sacituzumab govitecan for patients with breast cancer have sparked renewed interest in the realm of ADCs, he continues. This interest extends beyond breast cancer, encompassing a wide spectrum of other cancer types, Davis reports. The surge in interest has led to significant advancements and expansions in the potential applications of ADCs within the field of oncology, he notes, adding that this resurgence is revitalizing therapeutic options andopening new avenues for treating various cancers, thereby enhancing oncological care.

T-DXd, in particular, has generated promising results in clinical trials, showing efficacy in HER2-positive cancers resistant to other therapies, Davis reports. Sacituzumab govitecan, on the other hand, has had activity in triple-negative breast cancer and other solid tumors, offering new hope for patients with historically challenging-to-treat malignancies, he says.

As research continues to evolve, the development of ADCs remains an area of active investigation and innovation, Davis expands. These therapies combine the targeted specificity of monoclonal antibodies with the potent cytotoxic effects of chemotherapeutic drugs, aiming to deliver treatments directly to cancer cells and minimize systemic toxicity, he concludes.