Recent advancements in cancer treatment have emerged from the European Society for Medical Oncology (ESMO) congress, showcasing the innovative use of targeted antibody-drug conjugates (ADCs). These therapies function like Trojan horses, delivering chemotherapy directly into malignant cells, thereby enhancing treatment outcomes.
Over the past fifty years, the medical community has witnessed the evolution of cancer therapies, from the optimism surrounding chemotherapy to the emergence of immunotherapy, which utilizes the body”s immune defenses to combat tumors. Currently, the spotlight has shifted to ADCs, which are gaining traction due to their promising results across various cancer types, particularly breast cancer. This week, ESMO in Berlin highlighted studies demonstrating the efficacy of these precision therapies not only in metastatic stages but also in earlier stages of the disease.
ADCs are designed to target specific receptors on the surface of tumor cells. They consist of an antibody linked to a chemotherapy drug, which, upon binding to the tumor cell, releases the drug directly into the cell, leading to its destruction. Aleix Prat, director of the Clinic Barcelona Comprehensive Cancer Center, emphasized the potential of ADCs, stating, “They have come to stay. This is a validated approach that provides a pathway for further advancements.”
In breast cancer specifically, recent developments in ADCs have significantly altered the prognosis for aggressive tumors. For instance, one study presented at ESMO showed that the ADC trastuzumab-deruxtecan significantly increased survival rates among women with HER2-positive tumors, which represent around 20% of breast cancer cases. Another ADC, sacituzumab govitecan, was shown to be more effective than conventional chemotherapy for treating triple-negative breast cancer, which is particularly aggressive and affects about 15% of patients.
According to Javier Cortés, director of the International Breast Cancer Center in Barcelona and lead author of a pivotal study, ADCs have emerged as the first-line treatment option once metastasis occurs in breast cancer. He noted, “This study offers a significant improvement in the prognosis for these patients. We are making steady progress, albeit slowly but surely.”
The efficacy of ADCs is not restricted to advanced stages of cancer. A study published in the Annals of Oncology demonstrated that administering the ADC trastuzumab-deruxtecan prior to surgery in high-risk early-stage HER2-positive patients improved the rate of complete pathological response—indicating no residual tumor cells post-surgery. Oncologist Santiago Escrivá de Romaní remarked, “We found an 11% increase in complete pathological response with the addition of the ADC to the treatment regimen.”
Despite their benefits, the introduction of ADCs also brings new challenges, including potential toxicity and the need for careful patient selection. In Cortés” study, 66% of participants receiving the ADC experienced side effects, primarily gastrointestinal issues. However, these effects were generally considered more manageable compared to traditional chemotherapy.
As research continues, experts like Prat are hopeful that ADCs could lead to a significant reduction in cancer recurrence rates and improved survival across multiple cancer types. Paolo Tarantino from Dana-Farber Cancer Institute noted that this therapeutic strategy marks the beginning of a new chapter in oncology, characterized by more intelligent targeting and a deeper biological understanding of tumors.
Looking ahead, the potential for combining ADCs with other treatment modalities, such as immunotherapy, remains a key area of exploration. As the field of oncology evolves, the long-term impact of ADCs in the fight against cancer is expected to be profound.
