ADCs in Endocrine-Refractory Breast Cancer Treatment

Here’s a breakdown of the key details from the text, organized by the questions asked:

1. Updates in NCCN Guidelines for Endocrine-Refractory Breast Cancer:

Trastuzumab deruxtecan (T-DXd) is now a Category 1 preferred ‍agent in ⁣the first-line setting for patients with HER2-low disease, according too the NCCN guidelines.
This applies to patients considered endocrine ‍refractory,⁣ not just those in immediate crisis.

2. Trial Data Supporting Sacituzumab Use:

TROPiCS-02⁤ (NCT03901339) ⁣was a Phase 3⁣ study evaluating sacituzumab vs. physician’s choice chemotherapy (eribulin, capecitabine, vinorelbine, gemcitabine) in metastatic hormone receptor-positive, HER2-negative patients. Patient Population: Patients had progressed after⁢ at least one endocrine therapy,⁣ a taxane, and a CDK4/6 inhibitor, and had received 2-4 prior lines of chemotherapy.
Primary Endpoint: Progression-Free Survival (PFS)
Results:
Sacituzumab showed a statistically important ⁣improvement in⁤ median PFS: 5.5 months vs. 4.0 ⁣months with⁤ chemotherapy.

⁢ Overall Survival‍ (OS) was also significantly improved with sacituzumab: 14.4 months vs.11.2 months (HR 0.79,‍ 95% CI 0.65-0.96,P = .020).

3.⁣ Sacituzumab Tolerability in the Trial:

Treatment-emergent adverse events (AEs) were generally well-balanced, but there were slightly more Grade 3 AEs, as well as more dose⁢ delays and reductions ⁣ with sacituzumab.
No new⁤ safety signals were identified with extended ⁤follow-up.
* Key AEs to be mindful of: Neutropenia.