Dr Melissa Johnson Highlights Potential Lung Cancer Treatments in the Pipeline

The DLL3-specific T cell engagers for small cell lung cancer are exciting to watch, said Melissa Johnson, MD, program director of Lung Cancer Research at Sarah Cannon.

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What clinical trial and/or treatment in the pipeline most excites you?

Antibody drug conjugates have been approved in tumor types like breast cancer. We're looking now at HER2 or HER2 directed antibody drug conjugate for HER2-mutated lung cancer. We're looking at Dato-DXd and sacituzumab govitecan trop2 directed ADCs for patients in the second line, post [chemotherapy/immunotherapy] as well as patritumab deruxtecan, which is a HER3 antibody drug conjugate for patients who have acquired resistance to osimertinib. All of these drugs have in common that they work with a mechanism that's very different from chemotherapy and immunotherapy. They bind to the target and inject the cytotoxic toxin right in to the cancer cells and leave the other cells alone. We call antibody drug conjugates "smart bombs" for our patients. And those have a lot of promise in lung cancer.

I'm also excited about bispecifics. Bispecific T cell engagers are drugs that target with 2 different antibody heads, both the tumor and T cells and bring them together. I think that's probably one mechanism of resistance to [immunoncology] that we don't think about enough. Just because we're stimulating the immune system with checkpoint inhibitors doesn't mean that the immune system knows where to go to get to the lung cancer. And so these biospecifics make a lot of sense to me because they're actually binding to the cancer and coaxing the immune system to come to it. There are bispecifics being evaluated for all solid tumors, but in particular, the DLL3-specific T cell engagers for small cell [lung cancer] are exciting to me.