Sequencing Antibody Drug Conjugates in Breast Cancer: Exploring Future Roles

Area of Science:

• Oncology
• Pharmacology
• Biotechnology

Background:

• Antibody drug conjugates (ADCs) represent a significant advancement in breast cancer (BC) therapy.
• ADCs demonstrate efficacy across diverse BC subtypes, including HER2-positive, ER/PR-positive, and triple-negative breast cancer (TNBC).
• Evolution in ADC technology has led to increased efficacy compared to traditional chemotherapy.

Purpose of the Study:

• To review the pharmacology and current indications of novel ADCs: trastuzumab deruxtecan and sacituzumab govitecan.
• To highlight emerging ADCs and ongoing clinical trials, anticipating shifts in breast cancer treatment paradigms.
• To outline data and strategies for managing adverse events and sequencing ADC treatments, including resistance mechanisms.

Main Methods:

• Review of current literature on ADC pharmacology, clinical indications, and adverse events.
• Analysis of emerging ADCs and ongoing clinical trial data.
• Discussion of resistance mechanisms and treatment sequencing strategies.

Main Results:

• ADCs like trastuzumab emtansine, sacituzumab govitecan, and trastuzumab deruxtecan show high efficacy in various breast cancer subtypes.
• Newer generation ADCs offer improved outcomes compared to conventional chemotherapy.
• Adverse events and treatment sequencing post-progression remain key clinical challenges.

Conclusions:

• ADCs have revolutionized breast cancer treatment, offering potent therapeutic options across subtypes.
• Optimal management of ADC-related toxicities and resistance is crucial for maximizing patient benefit.
• Future research and clinical trials will continue to refine ADC applications and sequencing in breast cancer care.