Dato-DXd More Effective, Tolerable Than Chemo for Metastatic Breast Cancer

The investigational Trop2-directed antibody-drug conjugate (ADC) datopotamab deruxtecan (Dato-DXd) continued to demonstrate superiority to chemotherapy for patients with metastatic endocrine-resistant breast cancer, both in terms of efficacy and tolerability, results of a phase III trial presented at the San Antonio Breast Cancer Symposium showed.

In this exclusive MedPage Today video, Jasmine Singh Sukumar, MD, of the University of Texas MD Anderson Cancer Center in Houston, offers her take on the results of the trial, TROPION-Breast01, and what they mean for the future of ADCs in metastatic disease.

The following is a transcript of her remarks:

Here at San Antonio, we learned about the TROPION-Breast01 study, which looked at datopotamab deruxtecan, a Trop2 antibody-drug conjugate, compared with chemotherapy in metastatic hormone-positive breast cancer. And this was endocrine-resistant disease that has received two prior chemotherapies. This drug was compared to standard chemotherapy, and we learned at [the European Society for Medical Oncology congress] that this had an improved progression-free survival and was more effective.

But at San Antonio, now we’re understanding that this option is also more tolerable for patients. There’s less side effects and there’s an improved quality of life. And often we don’t see that with clinical trials. Often we see that with investigational agents there may be more toxicity than the standard option, but here we’re seeing just the opposite. So this may be a new treatment option for patients.

I think one unanswered question is how best are we going to sequence antibody-drug conjugates moving forward? It’s great that we have these options for patients and they’re rapidly emerging, but sequencing data is sparse. At San Antonio, we have many posters that are looking at real-world data of antibody-drug conjugates and sequencing them. And I think we need to understand are there any biomarkers that can predict resistance, resistance to the antibody, resistance to the payload, and maybe that will help us understand how best to sequence these therapies.