Management of ADC Toxicities in Lung Cancer

Opinion
Video
A panel of 6 experts on breast, lung, and gastrointestinal cancers

A nurse practitioner provides insights on toxicity management strategies for patients with lung cancer who are receiving antibody-drug conjugates.

Sponsored in part by Daiichi Sankyo. Content independently developed by OncLive®.

Transcript:

Benjamin P. Levy, MD: We only have 1 drug and that's great. It's pretty clean and straightforward, but we wrestle with learning, again, from breast [cancer] on how to manage this. Rasheda, I’ll talk to you about what we're seeing in terms of toxicity, how to manage patients, and our arguments about echocardiograms every12 weeks or just once.

Rasheda Persinger, MSN, AGNP-C, AOCNP: When I talk about adverse effects, I'll piggyback on what Kayla said, contrary to what you see, you see a little bit more adverse effects with this drug if you compare it to other drugs in lung cancer in terms of chemotherapy and so forth. It is better tolerated. One patient that I'm thinking of does have problems with tolerability, which is usually due to fatigue and nausea. There's one patient we've had to dose reduce due topoor tolerability as it relates to the fatigue and nausea, which she is tolerating better. Now, there may have been some other mitigating factors that contributed to it, but she is on this drug. So, when it comes to toxicity, you know, it's the normal things: making sure patients understand, educating them on the adverse effects, opening the lines of communication regardless of how often they need to speak to you to reiterate things. But I don't see a lot of adverse effects as it compares to, I'll say, nontargeted like Dr [Ben] Musher when he called it a chemo-targeted drug, I see fewer adverse effects than what I would see with chemotherapy and patients seem to tolerate it fairly well thus far. I don't know if you have. What would you say, Dr [Ben] Levy, would you agree with that as well, that it's fairly well tolerated?

Benjamin P. Levy, MD: I think it's a nice characterization. I view this drug through the prism of targeted therapy. We'll talk about TROP-2 ADCs, where I view them through the prism of chemotherapy. Most of our patients are not getting chemotherapy now, which is pretty remarkable and runs against every reason why I went into lung cancer because it was easy. That's a joke, but it is really interesting now that we've got 20 different drugs and most of our patients are not getting chemo, they're getting ADCs [antibody drug conjugates] or they're getting IO [immuno-oncology] or they're getting targeted therapies. And when that KRAS G12C story moves up front, which it will, that's 13% of all lung cancer. It's going to completely change the game again.

Transcript is AI-generated and edited for clarity and readability.

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