Antibody-drug conjugates (ADCs) are rapidly redefining the treatment landscape for patients with advanced non–small cell lung cancer (NSCLC) whose disease progresses after frontline therapy by improving response rates and extending durability of benefit, with the potential to move beyond the metastatic setting into earlier lines of care, according to Judy Wang, MD.
“Having a therapy that covers a patient head to toe is really powerful, and if that comes from ADCs that would be a huge plus because of its targeted ability, and [they have] a relatively better toxicity profile compared with some of the conventional therapies that we’re used to using in the advanced setting,” Wang said in an interview with OncLive®.
In the interview, which proceed a State of the Science Summit™ in Lung Cancer cochaired by Ben Creelan, MD, and Eduardo Sotomayor, MD, Wang, a medical oncologist and associate director of Drug Development at Florida Cancer Specialists & Research Institute in Sarasota, discussed the growing importance of comprehensive genomic profiling, the promise of central nervous system (CNS) activity, and the practical considerations to navigate as these therapies become more widely integrated into routine practice.
Based on the latest data with agents such as datopotamab deruxtecan-dlnk (Datroway), sacituzumab tirumotecan (sac-TMT), and telisotuzumab vedotin-tllv (Emrelis; Teliso-V), how do you view the role of ADCs in the treatment algorithm, and where are they showing the greatest clinical impact?
Wang: These ADCs have been approved in advanced NSCLC, either in EGFR-positive disease or in patients with c-MET–high expressing disease, which is great, as these patients often get a positive response to platinum-based chemoimmunotherapy. Invariably though these patients will [develop progressive disease]. What we are using in the second-line setting, outside of a trial or these other approved targeted agents, are drugs like docetaxel. With single-agent chemotherapy in the second line for NSCLC we’re really looking at an objective response rate of 20%, which is underwhelming.
Now we have these opportunities to offer these targeted therapies in which we’re seeing better response rates, longer durations of response, and ultimately, better tolerance, with a safety profile that is better than some of these conventional chemotherapy [drugs]. In the advanced setting, we’re seeing positive results, and with drugs that do well in the advanced setting, we’re always asking ourselves, ‘Can we push them into earlier lines? Can we offer patients earlier opportunities [to receive] these drugs which may promote even better response rates and durations of response?’
Read full interview: https://www.onclive.com/view/adcs-reshape-the-future-of-lung-cancer-care-from-second-line-therapy-to-earlier-intervention
