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ADCs Offer Exciting Potential in Lung Cancer

*July 2023*

Antibody-drug conjugates (ADC) represent one of the most exciting areas of ongoing development for the treatment of patients with non–small cell lung cancer (NSCLC) and small cell lung cancer (SCLC), according to Karen Reckamp, MD, MS, during a presentation at the 24th Annual International Lung Cancer Congress®.1

“This is the most exciting area, there are lots of agents, lots of new trials that are ongoing in patients,” said Reckamp, professor of medicine, Division Director, Medical Oncology, Cedars-Sinai, in Los Angeles, California. “We need to increase our knowledge of these ADCs to improve the delivery and reduce toxicity may improve outcomes for our patients.”

There are several factors that contribute to the efficacy and safety associated with ADCs, she said. Outside of the cytotoxic and antibody themselves, the drug-to-antibody ratio (DAR) is also of high importance. Across agents in development, the DAR ranges from 2 cytotoxic molecules per single antibody to 8. The increase of payload results in increased efficacy but also heightens the chance for premature release, which increases adverse events (AEs), Reckamp said. Other important factors are related to the expression of the target protein, and the location and mechanism of cleavage for the linker that attaches the cytotoxic to the antibody.

For the presentation, Reckamp displayed a list of 3 dozen ADCs currently in development for NSCLC. She commented that although the list had recently been developed, it was likely already out of date, given the fast pace and high interest of development in ADCs for NSCLC. “We are moving forward at fast forward with ADCs,” she said. “Although many are biomarker agnostic, we need to find a way to select patients.”

Among the list she displayed, she selected a few agents of high interest, based on their approval status or breakthrough designations received from the FDA. Read more.