ADCs therapy doubles the survival of patients with the “most aggressive breast cancer”

Triple-negative breast cancer (TNBC) is an aggressive type of breast cancer that accounts for 15% to 20% of breast cancer cases.

Triple-negative breast cancer usually shows a high proliferation rate at the time of diagnosis and is prone to recurrence and metastasis, especially with a high risk of metastasis to the lungs and brain. It is the breast cancer subtype with the worst prognosis.

“Triple negative” means that cancer cells lack three common hormone or protein receptors. Due to the lack of these three common receptors, triple negative breast cancer cannot use hormone therapy or targeted therapy targeting these receptors, and has long lacked effective treatment options. The application of ADCs has broken this treatment pattern and demonstrated its great potential in treating this difficult-to-treat breast cancer.

1. Sacituzumab Govitecan (Trodelvy)

Trodelvy is an ADC drug specifically for triple-negative breast cancer. It has shown good results in multiple clinical trials and was approved by the FDA in 2020.

According to a study in the New England Journal of Medicine (NEJM), Trodelvy significantly prolonged progression-free survival and overall survival and reduced the risk of tumor recurrence compared with chemotherapy alone in patients with metastatic triple-negative breast cancer:

• Progression-free survival: The median progression-free survival was 5.6 months in the Trodelvy group and 1.7 months in the chemotherapy group. •
Overall survival: The median overall survival was 12.1 months in the Trodelvy group and 6.7 months in the chemotherapy group.
• Objective response rate: 35% of patients achieved an objective response with Trodelvy and 5% with chemotherapy.

2. datopotamab deruxtecan (Dato-DXd)

Dato-DXd is an ADC drug targeting TROP-2, used to treat unresectable or metastatic hormone receptor (HR)-positive, HER2-negative breast cancer that has been previously treated with systemic therapy.

According to the results of the global clinical trial TROPION-Breast01 phase III trial, patients treated with Dato-DXd had a statistically significant and clinically meaningful improvement in progression-free survival compared with chemotherapy. At the same time, Dato-DXd also showed a good and easy-to-manage safety profile, with nausea and stomatitis being the most common treatment-related adverse events.