Potential for Targeting Trop-2 in HR+ Metastatic Breast Cancer

EP: 1.Patient Scenario 1: A Case of Stage II HR+ Breast Cancer

EP: 2.Role of CDK4/6 Inhibitors as First-Line Therapy for Metastatic HR+ Breast Cancer

EP: 3.HR+ Breast Cancer: Factors in Selecting First-Line Therapy for Metastatic Disease

EP: 4.Patient Scenario 2: A Case of Relapsed HR+ Metastatic Breast Cancer

EP: 5.Novel Treatment Modalities Under Investigation in HR+ Metastatic Breast Cancer

EP: 6.Considering HER2-Directed Therapy in HER2-Low Metastatic Breast Cancer

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EP: 7.Potential for Targeting Trop-2 in HR+ Metastatic Breast Cancer

EP: 8.Other Targets in HR+ Breast Cancer: PARP Inhibition and Immune Checkpoint Inhibitors

EP: 9.Evolving Landscape of HR+ Metastatic Breast Cancer Management

EP: 10.Recap: Treatment Paradigms in Metastatic Breast Cancer: Real-world Patient Cases

Transcript:

Jules Cohen, MD: What about sacituzumab govitecan[antibody drug conjugate] and ER-positive disease?

Neil M. Iyengar, MD: We have data from the TROPiCS-02 trial that Hope S. Rugo, MD, FASCO, presented. We see a benefit in the ER-positive population. Sacituzumab has been approved for use in the triple-negative population. I think we can consider our patients who have progressed on multiple lines of endocrine therapy as essentially being endocrine resistant and similar to the triple-negative population. It was encouraging to see the benefit of sacituzumab in that population. Now, notably, the population that was included in TROPiCS-02 included a subgroup of patients with HER2-low expression as well. We have seen data that’s stratified by HER2 expression IHC [immunohistochemistry] status and there was a consistent benefit across the different IHC levels of HER2 disease in the TROPiCS-02 trial. Then, here at San Antonio, we also saw data stratified by Trop2 expression. Trop2 expression was not predictive of the benefit with sacituzumab, which is consistent with earlier data, as well. That formed the rationale to not selecting patients by Trop2 status for the TROPiCS-02 trial. This is another ADC [antibody drug conjugate] that we can offer our patients who are endocrine therapy resistant. In terms of sequencing, we need to see more data to support the optimal sequencing strategy of ADCs. In patients who are HER2-low, my preference is to favor trastuzumab deruxtecan and perhaps use sacituzumab later on. Certainly, for those patients who are HER2-zero, we’d be using sacituzumab for now, until we start to see whether or not some of those HER2-zero patients are actually HER2 ultra-low.

Transcript edited for clarity.