Dr Levy on the Evolution of ADCs in NSCLC

Benjamin Philip Levy, MD, associate professor, oncology, Johns Hopkins University School of Medicine; clinical director, Medical Oncology, Sibley Memorial Hospital, Johns Hopkins Sidney Kimmel Cancer Center, discusses the evolution of antibody-drug conjugates (ADCs) in non-small cell lung cancer (NSCLC) following updated data to be read out for this treatment population throughout 2023.

At the 41st Annual CFS®, Levy discussed the use of ADCs in NSCLC. fam-trastuzumab deruxtecan-nxki (Enhertu; T-DXd) received FDA approval in 2022 in the second-line setting for patients with activating HER2–mutated NSCLC, Levy begins. However, with time, this class of agents is expanding to include other ADCs, specifically TROP2-directed ADCs, such as datopotamab deruxtecan (Dato-DXd; DS-1062a) and sacituzumab govitecan-hziy (Trodelvy), Levy adds. Data with these agents in advanced-age patients in the first- and second-line settings have been presented, he adds.

Additionally, patritumab deruxtecan (HER3-DXd), a HER2-directed ADC, is being investigated, specifically in the EGFR-mutant NSCLC patient population, Levy expands. Other ADCs are targeting CEACAM5 and MET overexpression. Levy explains that although there is currently 1 approved ADC addressing a small niche of patients with NSCLC, promising developments with this class of agents are on the horizon. It's crucial to examine these efforts comprehensively because several investigational ADCs may soon receive FDA approval, he emphasizes.

Levy continues that CFS is consistently important to hold because oncologic data are rapidly evolving. New compound drug classes are emerging, targeted therapies are gaining FDA approval for patients with specific genotypes, and immunotherapy combinations in the neoadjuvant setting, particularly chemo/immuno-oncology followed by immunotherapy after surgery, are becoming established, he emphasizes. The introduction of ADCs into the NSCLC treatment paradigm adds another layer of excitement. Witnessing the evolution of these treatment strategies over time and the speed at which they're progressing is exhilarating, he says. The wealth of data presented at previous meetings in 2023 was substantial, making the review of these data at CFS highly relevant. ADCs are poised to significantly impact the field of lung cancer treatment, Levy concludes.