Selecting Between Frontline ADCs in Clinical Practice

With both pivotal trials reviewed, the panel discusses how to reconcile the data when counseling an individual patient. Panelists acknowledge the limitations of cross-trial comparison while noting that the two studies shared more similarities than differences, with crossover standing out as a key distinction affecting survival interpretation. The conversation outlines scenarios where the choice becomes more straightforward, such as a contraindication to one agent, relevant comorbidities, prior treatment experience, or a patient's preference for a less frequent schedule. For patients with high disease burden or symptomatic, rapidly progressing disease, the discussion considers how response rate may inform selection. Panelists emphasize that for most patients, both agents are reasonable options, and the decision often comes down to differing toxicity profiles and required prophylaxis. The segment closes by considering the smaller subset of patients for whom an ADC may not be the preferred first-line choice. Viewers gain a practical decision-making framework.