Current landscape of sequencing ADCs in metastatic breast cancer

Antibody-drug conjugates (ADCs) have revolutionized the care of advanced breast cancer. ADCs pair an antibody targeted against a tumor-associated antigen with a cytotoxic payload, aiming to deliver therapy more effectively and with fewer off-target toxicities. Given the growth of ADCs in the past few years, patients are now candidates for multiple agents sequentially. Optimal strategies for sequencing ADCs are not yet known. Here we review retrospective data on ADC sequencing, translational understanding of mechanisms of resistance, and novel ADCs and combination agents in the pipeline that aim to improve upon currently available care.