Expert Discussion on Antibody-Drug Conjugates in HER2+/- Breast Cancer

Tanya Gupta, MD, medical oncologist in the Stanford University Department of Medicine, Division of Medical Oncology, discusses the current landscape of antibody-drug conjugates (ADCs) for breast cancer subtypes beyond HER2-positive disease.

Ado-trastuzumab emtansine (T-DM1; Kadcyla) for the treatment of HER2-positive disease was the first to be approved in 2013, followed by fam-trastuzumab deruxtecan-nxki (Enhertu; T-DXd), which gained accelerated approval from the FDA for the treatment of adult patients with unresectable or metastatic HER2-positive breast cancer who had received 2 or more prior HER2-targeted therapies in the metastatic setting.

Sacituzumab govitecan (Trodelvy) is a treatment option that is approved for patients with advanced triple-negative breast cancer who have received 2 or more prior systemic therapies, at least 1 of which was in the metastatic setting, as well as in hormone receptor-positive/HER2-negative advanced disease given prior endocrine therapy and at least 2 additional systemic therapies.

Transcription:

0:09 | There are multiple antibody-drug conjugates that have now been approved, as well as multiple antibody-drug conjugates that are being studied in the field of breast oncology. The currently approved antibody-drug conjugates are trastuzumab emtansine, also known as T-DM1, trastuzumab deruxtecan, also known as T-DXd, sacituzumab govitecan.

0:36 | In regard to your question about antibody-drug conjugates that are being used beyond the HER2-positive space, T-DXd and sacituzumab have indications outside of conventionally defined HER2-positive disease. Specifically, T-DXd is used in HER2-low disease, which is a disease where the immunohistochemistry result is 1+ or 2+ IHC result that is negative. Sacituzumab is indicated both in triple negative breast cancer and hormone receptor-positive, HER2-negative breast cancer, both in the advanced setting.