Current and Emerging ADCs Transforming Cancer Care

Antibody-drug conjugates (ADCs) continue to expand treatment options across multiple cancer types, with several established agents and new approvals shaping clinical practice. In an interview with Oncology Nursing News, Kelsey Martin, APRN, AG-ACNP-BC, AOCNP, a nurse practitioner at Sarah Cannon Research Institute in Nashville, Tennessee, highlighted key ADCs currently in use and those on the horizon.

In breast cancer, fam-trastuzumab deruxtecan-nxki (T-DXd; Enhertu) plays an important role, particularly for patients with HER2-positive and HER2-low disease. Another long-standing ADC in this space is ado-trastuzumab emtansine (T-DM1; Kadcyla). Sacituzumab govitecan (Trodelvy) remains utilized exclusively in breast cancer at this time, while datopotamab deruxtecan (Dato-DXd; Datroway) is now approved for both breast and lung cancers.

Bladder cancer treatment often incorporates enfortumab vedotin (Padcev), a widely used ADC in that setting. For lung cancer, several c-Met–targeted ADCs are emerging, along with HER3-directed options like patritumab deruxtecan, a drug in development for which a BLA was withdrawn in May. According to Martin, research continues to diversify ADC targets, offering more individualized approaches for patients across tumor types.

Transcript:

New [ADCs] come out all the time. I’m most familiar with breast cancer since I work mostly in that realm. We use a lot of trastuzumab deruxtecan. That also can overlap with bladder or lung [cancer], because patients that are HER2-positive can receive that. In breast cancer, it can be used in the HER2-low setting.

Kadcyla, or T-DM1 has been around for a while. It was our first ADC that can be used in the HER2-positive breast cancer setting, as well. Right now, sacituzumab govitecan is only used in the breast setting. Datopotamab deruxtecan is approved now in the lung and breast cancer settings as well.

The main thing that they’re using a lot in bladder cancer right now is enfortumab vedotin. That one is used most often in bladder cancer as their ADC target.

Lung cancer has a couple of c-Met antibody-drug conjugates. They’re coming out with HER3 antibody-drug conjugates like patritumab deruxtecan. There are all kinds of things coming out, and hopefully more will come as trials are done, and all of them have different targets. All of them have special components to them. But in general, we treat patients very similarly with all the different therapies.

This transcript has been edited for clarity and conciseness.