Next-generation antibody-drug conjugates for breast cancer: Moving beyond HER2 and TROP2
Ilana Schlam1, Ruth Moges2, Stefania Morganti3
1Department of Hematology and Oncology, Tufts Medical Center, Boston, MA, USA.
Abstract:
Antibody-drug conjugates (ADCs) have reshaped the treatment of several malignancies, including breast cancer. Two ADCs are currently approved for the treatment of each breast cancer subtype, including the HER2 targeted ADCs trastuzumab emtansine (T-DM1) and trastuzumab deruxtecan (T-DXd), and the TROP2-targeted ADC sacituzumab govitecan. Each of the ADC components (antibody, linker, and payload) plays a key role in determining the efficacy and toxicity profile of an individual ADC, and their modification can lead to major changes in the clinical profile of these agents. Leveraging the knowledge from three decades of development in the field, several novel ADCs are currently being investigated. Some approaches include targeting different antigens beyond the established HER2/TROP2, or evaluating innovative constructs, such as bispecific ADCs, ADCs with dual payload, immune-modulating ADCs, radionuclide drug conjugates, and masked ADCs, among others. In this review article we discuss the evolving landscape of novel ADCs, highlighting opportunities and challenges emerging in the field.
Insights
Antibody-drug conjugates (ADCs) are revolutionizing cancer therapy, particularly for breast cancer. Ongoing research explores novel ADCs with innovative designs and targets to improve efficacy and reduce toxicity for better patient outcomes.
Area of Science:
- Oncology
- Pharmacology
- Biotechnology
Background:
- Antibody-drug conjugates (ADCs) have significantly advanced cancer treatment, with approved agents for breast cancer subtypes targeting HER2 and TROP2.
- The efficacy and safety of ADCs are determined by their antibody, linker, and payload components, which can be modified to alter clinical profiles.
Purpose of the Study:
- To review the evolving landscape of novel antibody-drug conjugates (ADCs) in cancer therapy.
- To highlight emerging opportunities and challenges in the development of next-generation ADCs.
Main Methods:
- Literature review of current and investigational antibody-drug conjugates.
- Analysis of ADC components and novel construct designs.
Main Results:
- Established ADCs targeting HER2 and TROP2 have transformed breast cancer treatment.
- Numerous novel ADC strategies are under investigation, including targeting new antigens and employing innovative designs like bispecific ADCs, dual payloads, and immune-modulating constructs.
Conclusions:
- The field of ADCs is rapidly advancing, offering promising new therapeutic avenues for various malignancies.
- Continued innovation in ADC design and targeting holds significant potential for improving cancer treatment outcomes.
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