Opinion
Video
Earlier Introduction of Antibody-Drug Conjugates
Author(s):
Innovative antibody drug conjugates are advancing in ovarian cancer treatment, exploring new maintenance therapies and biomarker-driven approaches for improved outcomes.
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.”
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