Dr Davis on the Potential For ADCs to Continue to Reshape Breast Cancer Treatment

Andrew Davis, MD, assistant professor of medicine, Division of Medical Oncology, Washington University School of Medicine, medical oncologist, Siteman Cancer Center, discusses how the continued development of antibody-drug conjugates (ADCs) could reshape the breast cancer treatment paradigm. He also explains how the continued emergence of different ADCs within the breast cancer space will also present new questions that should be addressed in future clinical trials to maximize the benefits of these agents for patients.

Davis notes that with approximately 200 different ADCs are currently in preclinical and clinical development across various tumor types, including breast cancer. Given the volume of ADCs currently under development, these agents have the potential to transform the treatment landscape across various tumor types, Davis continues, adding that the emergence of additional ADCs will also present novel clinical questions regarding their role within the oncology space.

As more ADCs are developed, there will be a need to evaluate different payloads and their sequencing in clinical trials, Davis says. Determining the optimal sequencing for ADCs with different payloads will be crucial for optimizing their therapeutic impact, he notes.

Davis also emphasizes the necessity of exploring novel payloads. For example, some ADCs that have already reached clinical practice feature topoisomerase I inhibitor payloads, and ongoing clinical trials are exploring payloads that would differentiate these novel ADCs, Davis continues.

Furthermore, Davis addresses the importance of learning more about and improving upon the structural and delivery aspects of current ADCs. Using novel approaches regarding the design and engineering of ADCs, including the linker used, the agent’s chemistry, and the drug-to-antibody ratio, will play a critical role in the efficacy and safety profiles of novel agents under investigation in clinical trials, he says. Specifically for safety, changes in design could help improve off-target toxicity, and Davis concludes by noting that those in the field of breast cancer are eagerly awaiting data for a number of novel ADCs.