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Efficacy of administration sequence: Sacituzumab Govitecan and Trastuzumab Deruxtecan in HER2-low metastatic breast cancer
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Efficacy of administration sequence: Sacituzumab Govitecan and Trastuzumab Deruxtecan in HER2-low metastatic breast cancer
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Efficacy of administration sequence: Sacituzumab Govitecan and Trastuzumab Deruxtecan in HER2-low metastatic breast cancer
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Journal Article
Efficacy of administration sequence: Sacituzumab Govitecan and Trastuzumab Deruxtecan in HER2-low metastatic breast cancer
2024
Overview
Background
Current guidelines recommend that patients with HER2-low metastatic breast cancer (MBC) receive sequentially two antibody–drug conjugates (ADCs): Sacituzumab Govitecan (SG) and Trastuzumab Deruxtecan (T-DXd), despite a similar payload. However, the effectiveness of one after another is unknown.
Methods
ADC-Low is a multicentre, retrospective study evaluating the efficacy of SG and T-DXd, one after another, with or without intermediary lines of chemotherapy, in patients with HER2-low MBC.
Results
One hundred and seventy-nine patients were included: the majority with HR-negative tumours received SG first (ADC1) (
n
= 100/108) while most with HR-positive tumours received T-DXd first (
n
= 56/71). Median progression-free survival 2 was short: 2.7 months (95% CI: 2.4–3.3) in the whole population, respectively, 3.1 (95% CI: 2.6–3.6) and 2.2 months (95% CI: 1.9–2.7) for patients receiving T-DXd or SG second (ADC2). Intermediary lines of chemotherapy between ADC1 and ADC2 had no impact. Primary resistance to ADC2 occurred in 54.4% of patients. Certain patients showed initial response to ADC2.
Conclusions
Clinical benefit of sequentially administered SG and T-DXd is limited for most patients. Nevertheless, a subset of patients might benefit—on the short term—from a second ADC. Additional studies are needed to identify patients who could benefit from two ADCs with similar payloads.
Publisher
Nature Publishing Group UK,Nature Publishing Group,Cancer Research UK
Subject
/ Adult
/ Aged
/ Antibodies, Monoclonal, Humanized - administration & dosage
/ Antibodies, Monoclonal, Humanized - therapeutic use
/ Antineoplastic Combined Chemotherapy Protocols - therapeutic use
/ Biomedical and Life Sciences
/ Breast Neoplasms - drug therapy
/ Breast Neoplasms - pathology
/ Camptothecin - administration & dosage
/ Camptothecin - analogs & derivatives
/ Camptothecin - therapeutic use
/ Female
/ Humans
/ Immunoconjugates - administration & dosage
/ Immunoconjugates - therapeutic use
/ Oncology
/ Receptor, ErbB-2 - metabolism
/ Trastuzumab - administration & dosage
/ Trastuzumab - therapeutic use
/ Tumors
