Lowell L. Hart, MD, FACP, discusses the utility of antibody-drug conjugates in HER2-positive breast cancer.
Lowell L. Hart, MD, FACP, scientific director of Clinical Research at Florida Cancer Specialists and Research Institute, and associate professor of Internal Medicine at Wake Forest School of Medicine, discusses the utility of antibody-drug conjugates (ADCs) in HER2-positive breast cancer.
In February 2013, ado-trastuzumab emtansine (T-DM1; Kadcyla) was approved to treat patients with metastatic HER2-positive breast cancer who had previously received trastuzumab (Herceptin) and a taxane. The label was updated in May 2019 to include use as adjuvant treatment in patients with HER2-positive early breast cancer who have residual invasive disease after neoadjuvant chemotherapy and trastuzumab (Herceptin)-based treatment.
Historically, patients with residual disease at the time of surgery continued on trastuzumab for the remainder of a year. Now, patients are given T-DM1 rather than trastuzumab according to data from the phase III KATHERINE trial, explains Hart.
Another ADC, trastuzumab deruxtecan (T-DXd; DS-8201), demonstrated an objective response rate of approximately 61% in patients with heavily pretreated advanced disease in the randomized phase II DESTINY-Breast01 trial. Data from the trial were presented at the 2019 San Antonio Breast Cancer Symposium. T-DXd has a higher drug to antibody ratio and a different payload than T-DM1, concludes Hart.