Earlier Introduction of Antibody-Drug Conjugates

Video content is prompted by the following:

Early Introduction of Antibody-Drug Conjugates

Key Themes:

• Clinical trials evaluating antibody-drug conjugates (ADCs) in earlier treatment settings
• Integration of biomarkers in treatment decision-making
• Balancing efficacy against toxicity profiles

Notable Insights:

• ADCs are advancing to earlier treatment settings through clinical trials:
• GLORIOSA study: mirvetuximab in platinum-sensitive maintenance

• Study 420: Carboplatin plus mirvetuximab followed by mirvetuximab maintenance

• Neoadjuvant studies with mirvetuximab

• Trastuzumab deruxtecan in frontline maintenance
• Dr Moore discussed the challenge of prioritizing biomarkers when multiple are present: “I would always prioritize a BRCA mutation. I would do a PARP right now, but maybe that will change with time.... If I’ve got HER2+ and I’m also folate medium, what does that mean in terms of the best medicine to use for that patient frontline as maintenance therapy?”
• ADCs have significant toxicities (pneumonitis, mucositis, eye toxicity, hematologic toxicity), requiring careful consideration of benefit-to-risk ratio when using them in earlier settings.

The panel concluded with Dr Moore emphasizing both excitement about these novel therapies and caution about the need for better biomarker understanding: “I do think they belong in frontline in some settings right now.... But I also think we don’t fully understand the context of the biomarkers. So, I think there’s some reason to be cautious.”