Breast Cancer, Genitourinary Cancers, Lung Cancer, Gastric Cancer CME ACCREDITED Watch Time: 19 mins

touchEXPERT OPINIONS Antibody-drug conjugates for solid tumours: Current understanding and future directions

Watch Prof. Giuseppe Curigliano discuss the latest advances in the antibody-drug conjugates for the treatment of solid tumours.

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Expert Interview
What is the current status of ADCs for solid tumours

Prof. Giuseppe Curigliano reviews and interprets key efficacy data from 2020 for ADCs in solid tumours as well as considering the safety profiles for these treatments.

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Interview Questions

In this interview Prof. Giuseppe Curigliano answers the follow questions:

  • How do antibody-drug conjugates differ from other treatments for solid tumours?
  • What were the key efficacy findings in solid tumours for emerging antibody-drug conjugates in 2020?
  • What are the key adverse events associated with antibody-drug conjugates?
  • What are the benefits of antibody-drug conjugates over other available treatments for solid tumours in clinical practice?
 
Expert Interview
What’s next for ADCs in 2021 and beyond?

Prof. Giuseppe Curigliano evaluates how ADCs may be incorporated into clinical practice for managing solid tumours as well as considering what the future holds for these treatments.

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Interview Questions

In this interview Prof. Giuseppe Curigliano answers the follow questions:

  • When and how would emerging antibody-drug conjugates be incorporated into the treatment paradigm?
  • How do you manage adverse events and monitor patients receiving antibody-drug conjugates?
  • Which ongoing clinical trials of emerging antibody-drug conjugates are of most interest?
  • What are the future directions for antibody-drug conjugates?
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Overview & Learning Objectives
Overview

In this activity, an expert in antibody-drug conjugates answers questions on the latest advances in the treatment of solid tumours with antibody-drug conjugates.

This activity has been jointly provided by Oakstone and touchIME ONCOLOGY. Oakstone Publishing is accredited by the ACCME to provide continuing medical education to physicians.

Target audience

This activity has been designed to meet the educational needs of oncologists involved in the management of solid tumours.

Disclosures

Oakstone Publishing has assessed conflict of interest with its faculty, authors, editors, and any individuals who were in a position to control the content of this CME activity. Any identified relevant conflicts of interest were resolved for fair balance and scientific objectivity of studies utilized in this activity. Oakstone Publishing’s planners, content reviewers, and editorial staff disclose no relevant commercial interests.

Faculty

Prof. Giuseppe Curigliano discloses: Advisory Board honoraria from Ellipsis; Advisory Board/lecture honoraria from AstraZeneca, Daichii Sankyo, Eli Lilly, Novartis, Pfizer, Roche, and Seagen.

Content reviewer

Walter Murray Yarbrough, MD, FACP, has no financial interests/relationships or affiliations in relation to this activity.

Touch Medical Director

Alison Scott has no financial interests/relationships or affiliations in relation to this activity.

Requirements for Successful Completion

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Oakstone Publishing and touchIME. Oakstone Publishing is accredited by the ACCME to provide continuing medical education for physicians.

The European Union of Medical Specialists (UEMS) – European Accreditation Council for Continuing Medical Education (EACCME) has an agreement of mutual recognition of continuing medical education (CME) credit with the American Medical Association (AMA). European physicians interested in converting AMA PRA Category 1 Credit™ into European CME credit (ECMEC) should contact the UEMS (www.uems.eu).

Oakstone Publishing designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

In order to receive credit for this activity, participants must review and complete the post-test and evaluation form. Statements of credit are awarded upon successful completion of the post-test and evaluation form.

Date of original release: 11 March 2021. Date credits expire: 11 March 2022.

Learning Objectives

After watching this activity, participants should be better able to:

  • Evaluate the efficacy and safety data for emerging ADCs in solid tumours
  • Discuss how emerging ADCs may be incorporated into the treatment paradigm for patients with solid tumours
  • Summarise novel ADCs and the ongoing clinical trials in patients with solid tumours
About Prof. Giuseppe Curigliano
Prof. Giuseppe Curigliano

Associate Professor of Medical Oncology, University of Milan, Milan, Italy

Giuseppe Curigliano, MD, PhD, is Associate Professor of Medical Oncology at the University of Milan and the Head of the Division of Early Drug Development at the European Institute of Oncology, IRCCS, Italy. He is a clinician and researcher specializing in early drug development for patients with solid tumours with a special commitment to breast cancer.

Prof. Curigliano has been a member of the Italian National Health Council since 2018 and, in 2019, he served as Chair of the Scientific Committee of The Lega Nazionale Lotta ai Tumori. He has served as a Member of the European Society for Medical Oncology (ESMO) Breast Cancer Faculty since 2001 and is currently the Faculty Coordinator. He has also served on the Scientific Committee for the St Gallen Conference since 2011, and was the Scientific Co-Chair in St Gallen 2017 and 2019. read more

Prof. Curigliano has been an Editorial Board Member for Annals of Oncology since 2014, and serves as Co-Editor in Chief of The Breast, Co-Editor-in-Chief of Cancer Treatment Reviews, Associate Editor of the European Journal of Cancer, and Editor of the Journal of Clinical Oncology. He also serves on the European School of Oncology (ESO) faculty committee.

Prof. Curigliano serves as the Chair of the Guidelines Committee for ESMO and is a Council Member. He is also the Chair of the Nomination Committee. He served as the Scientific Chair of the IMPAKT ESMO meeting that was held in Brussels in 2014 and as the Breast Cancer (metastatic) Track Chair of the ESMO 2014 meeting in Madrid. He served as Scientific Co-Chair of the ESMO Breast Cancer Congress in 2019 and 2020.

Prof. Curigliano was awarded with the first ESO Umberto Veronesi Award in Vienna in 2017 and with the Fellowship of the European Academy of Cancer Sciences in Paris in 2017. He has contributed to over 390 peer-reviewed publications.

Prof. Giuseppe Curigliano discloses: Advisory Board honoraria from Ellipsis; Advisory Board/lecture honoraria from AstraZeneca, Daichii Sankyo, Eli Lilly, Novartis, Pfizer, Roche, and Seagen.

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Question 1/5
Which of the following is an important part of an antibody-drug conjugate?
Correct

An antibody-drug conjugate consists of a monoclonal antibody connected to a cytotoxic payload (drug) via a chemical linker. The antibody targets highly expressed antigens on the tumour cell surface, allowing the payload drug to be specifically targeted to tumour cells and not normal cells.

Gauzy-Lazo L, Sassoon I, Brun MP. Advances in Antibody-Drug Conjugate Design: Current Clinical Landscape and Future Innovations. SLAS Discov: Adv. Sci. Drug Discov. 2020;25:843–68.

Question 2/5
In the phase III ASCENT trial, in patients with metastatic triple-negative breast cancer, how did sacituzumab govitecan compare with treatment of physician’s choice of chemotherapy?
Correct

ASCENT is the first phase III study of an antibody-drug conjugate with significant progression-free survival improvement over standard of care chemotherapy in pretreated metastatic triple-negative breast cancer, confirming the clinical activity and safety profile of sacituzumab govitecan monotherapy. Overall response rate was 35% for sacituzumab govitecan versus 5% for treatment of physician’s choice (p<0.0001).

Bardia A, Tolaney SM, Loirat D, et al. ASCENT: A randomized phase III study of sacituzumab govitecan (SG) vs treatment of physician’s choice (TPC) in patients (pts) with previously treated metastatic triple-negative breast cancer (mTNBC). Ann. Oncol. 2020;31:S1149–50.

Question 3/5
You prescribe an antibody-drug conjugate for your patient, which common class-effect adverse event do you anticipate may occur?
Correct

Haematologic adverse events, such as neutropenia, are common in all antibody-drug conjugates. This is due to unwanted drug release in the bloodstream. There is a risk of interstitial lung disease with trastuzumab deruxtecan, however, this is a rare event.

Wolska-Washer A, Robak T. Safety and tolerability of antibody-drug conjugates in cancer. Drug Saf. 2019;42:295–314.

Question 4/5
Your patient is a 69-year-old woman with ER-, HER2+ breast cancer. Which treatment should she have received prior to administering trastuzumab deruxtecan as a second-line treatment?
Correct

Trastuzumab durextecan is indicated for the treatment of adult patients with unresectable or metastatic HER2+ breast cancer who have received two or more prior anti-HER2-based regimens in the metastatic setting.

US Food and Drug Administration. Trastuzumab deruxtecan prescribing information. 2019. Available at: www.accessdata.fda.gov/drugsatfda_docs/label/2019/761139s000lbl.pdf (accessed 12 February 2021).

Question 5/5
Your patient is currently receiving enfortumab vedotin at a dose of 1.25 mg/kg on Days 1, 8, and 15 of a 28-day cycle. The patient has presented with a Grade 3 neutropenia; what is the appropriate course of action?
Correct

The recommended dose of enfortumab vedotin is 1.25 mg/kg (up to a maximum of 125 mg for patients ≥100 kg) administered as an intravenous infusion over 30 minutes on Days 1, 8, and 15 of a 28-day cycle until disease progression or unacceptable toxicity. In the event of Grade 3 haematologic toxicity, such as neutropenia, prescribing information recommends to withhold further treatment until Grade ≤1, then resume treatment at the same dose level or consider dose reduction by one dose level in the following order: 1.0 mg/kg up to 100 mg, 0.75 mg/kg up to 75 mg, 0.5 mg/kg up to 50 mg.

US Food and Drug Administration. Enfortumab vedotin prescribing information. 2019. Available at: www.accessdata.fda.gov/drugsatfda_docs/label/2019/761137s000lbl.pdf (accessed 12 February 2021).

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