A Review of Current and Future Antibody Drug Conjugates in Breast Cancer
Megan Randall1, Rachel Akers1, Ruta Rao2
1Rush University Medical Center, 1725 W. Harrison Street, Suite 809, Chicago, IL, 60612, USA.
Opinion Statement:
Antibody-drug conjugates (ADCs) are a novel class of anti-cancer agents that have changed the standard of care for patients with breast cancer. Their targeted approach delivers potent anti-cancer drugs to cancer cells bearing specific surface antigens, thereby maximizing anti-cancer effects and minimizing systemic toxicity. Currently, there are three ADCs available for use in breast cancer: trastuzumab emtansine for HER2 positive breast cancer (early stage and metastatic), trastuzumab deruxtecan for HER2 positive and HER2 low breast cancer (metastatic) and sacituzumab govitecan for triple negative and hormone receptor positive (HR +), HER2 negative breast cancer(metastatic). Trials have shown that these drugs have improved both progression free survival and overall survival in the metastatic setting, and trastuzumab emtansine has improved overall survival in early-stage breast cancer as well. The future of this class of compounds is very exciting. This field is rapidly evolving with new ADCs being investigated and clinical trials looking at the use of known ADCs in earlier stage disease.
Insights
Antibody-drug conjugates (ADCs) offer targeted cancer therapy, improving survival for breast cancer patients. This evolving field shows promise for earlier disease stages and new ADC development.
Area of Science:
- Oncology
- Pharmacology
- Biotechnology
Background:
- Antibody-drug conjugates (ADCs) represent a significant advancement in cancer treatment.
- Their mechanism involves targeted delivery of cytotoxic agents to cancer cells via specific surface antigens.
- This targeted approach aims to enhance efficacy while reducing systemic toxicity.
Purpose of the Study:
- To review the current landscape of ADCs in breast cancer treatment.
- To highlight the impact of approved ADCs on patient survival outcomes.
- To discuss the future directions and ongoing research in ADC development for breast cancer.
Main Methods:
- Review of clinical trial data and published literature on ADCs in breast cancer.
- Analysis of efficacy and safety profiles of currently available ADCs.
- Exploration of ongoing research and clinical trials for novel ADCs and earlier disease applications.
Main Results:
- Three ADCs are approved for breast cancer: trastuzumab emtansine (HER2+ early/metastatic), trastuzumab deruxtecan (HER2-positive/low metastatic), and sacituzumab govitecan (metastatic triple-negative/HR+).
- Clinical trials demonstrate improved progression-free and overall survival in the metastatic setting.
- Trastuzumab emtansine has shown improved overall survival in early-stage breast cancer.
Conclusions:
- ADCs have become a cornerstone in breast cancer therapy, altering the standard of care.
- The efficacy of ADCs in improving survival outcomes is well-established in metastatic disease.
- The field is rapidly advancing with new ADCs in development and investigation for earlier stages of breast cancer.
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