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Antibody-drug conjugates in breast cancer: Marching from HER2-overexpression into HER2-low
1The First Clinical Medical College of Nanjing Medical University, Nanjing 211166, China.
Abstract:
The recent decade has witnessed a vigorous prosper of antibody-drug conjugates (ADCs) in solid tumors including breast cancer. Integrating the specificity of monoclonal antibodies and potency of cytotoxic drugs, ADCs are capable of delivering cytotoxic agents directly to tumor cells and surrounding accomplices with heterogeneous antigen expression by exerting the distinctive bystander effect. Up till now, three ADCs (T-DM1, T-DXd and SG) have attained the official approval and stepped into clinical practices in breast cancer, with numerous promising products in the pipeline. As an unprecedented breast cancer subgroup identified following solidified drug benefit, the cognitive and therapeutic paradigm of HER2-low population which was previously thought lacking definite targets and efficacious regimens has been thoroughly rewritten by ADCs, and several encouraging achievements are expected in ongoing trials. Herein, we discuss the contrived knowledge, latest advancements and future perspectives of ADCs in HER2-overexpressing and HER2-low breast cancer.
Insights
Antibody-drug conjugates (ADCs) are revolutionizing breast cancer treatment, particularly for HER2-low patients. These therapies deliver potent drugs directly to cancer cells, offering new hope and effective regimens.
Area of Science:
- Oncology
- Pharmacology
Background:
- Antibody-drug conjugates (ADCs) have significantly advanced solid tumor treatment, especially in breast cancer.
- ADCs combine monoclonal antibodies with cytotoxic drugs for targeted tumor cell delivery.
- The bystander effect of ADCs enhances efficacy in tumors with heterogeneous antigen expression.
Purpose of the Study:
- To review the current knowledge, recent advancements, and future outlook of ADCs in breast cancer.
- To highlight the impact of ADCs on HER2-overexpressing and HER2-low breast cancer subgroups.
- To discuss the paradigm shift in treating HER2-low breast cancer due to ADC therapies.
Main Methods:
- Review of recent clinical trials and approved antibody-drug conjugates.
- Analysis of the mechanism of action, including the bystander effect.
- Discussion of therapeutic strategies for HER2-overexpressing and HER2-low breast cancer.
Main Results:
- Three ADCs (T-DM1, T-DXd, SG) are approved for breast cancer treatment.
- ADCs have redefined treatment paradigms for HER2-low breast cancer.
- Ongoing trials show promising results for ADCs in various breast cancer subtypes.
Conclusions:
- ADCs represent a major breakthrough in breast cancer therapy, offering targeted treatment options.
- The development of ADCs has opened new avenues for previously untargetable patient populations, like HER2-low breast cancer.
- Future research and clinical trials are expected to further expand the role of ADCs in managing breast cancer.
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