Sequential Cytotoxic Payloads Against Metastatic Breast Cancer

Clinical Takeaway

: In a retrospective observational study, treatment with sacituzumab govitecan after T-DXd was associated with shorter progression-free survival.

Context

The use of antibody-drug conjugates (ADCs, wherein an antitumor antibody is linked to a cytotoxic payload) has improved outcomes across many tumor types. For the three ADCs thus far approved in the setting of breast cancer, the payload is a topoisomerase 1 inhibitor: trastuzumab deruxtecan (T-DXd), sacituzumab govitecan (SG), or datopotamab deruxtecan. T-DXd is used for HER2-positive metastatic breast cancer as well as HER2-low and HER2-ultralow disease (including endocrine-refractory disease).

Are ADCs for breast cancer especially beneficial if used in sequence (with T-DXd used most often as the initial agent)? Investigators conducted a retrospective observational study of a database spanning 280 U.S. clinics. Patients who received T…

Reviewing Author

William Gradishar, MD

Disclosures

Consultant/Advisory BoardLilly; AstraZeneca; Gilead

Grant/Research SupportBreast Cancer Research Foundation

Editorial BoardsClinical Breast Cancer; Oncology; Annals of Surgery; Breast Cancer Research and Treatment

Leadership Positions in Professional SocietiesNational Comprehensive Cancer Network (Chair, Breast Cancer Panel); American Board of Internal Medicine (Medical Oncology Board)