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Latest Advances in ADC Therapies for Breast Cancer Highlighted at ASCO

Reshma Mahtani, D.O.

Physician-investigators at Miami Cancer Institute, part of Baptist Health, are preparing to launch a new breast cancer clinical trial that will provide critical information regarding the sequential use of antibody drug conjugates (ADCs) in patients with metastatic breast cancer. The study builds upon previous research conducted in collaboration with several institutions that evaluated the sequential use of ADCs and was presented last year at the San Antonio Breast Cancer Symposium. Further analyses of this data set will be presented at the annual meeting of the American Society of Clinical Oncology (ASCO), on June 2 at 9 a.m. CDT.

Reshma Mahtani, D.O., chief of breast medical oncology at Miami Cancer Institute, is principal investigator of the upcoming multi-institutional study, “Sequencing Antibody Drug Conjugates in ER+/HER2 LOW MBC (SERIES)” - NCT06263543.

The prospective study will help develop more-personalized treatment approaches, as it will further clarify the optimal sequencing of ADCs, which will spare toxicities of therapies to patients that are not likely to benefit. The other trial locations are UCLA Comprehensive Cancer Center in Los Angeles and the Winship Cancer Institute at Emory University in Atlanta.

“Personalized medicine is the wave of the future,” Dr. Mahtani explained. “We aim to give the right drug to the right patient. As we better understand the biological drivers and mechanisms of resistance to therapies, we develop more customized treatment plans. With this approach we’ve seen that patients are living longer and enjoying a better quality of life.”

ADCs combine an antibody that targets a protein on the cancer cell, along with potent chemotherapy drugs. They are known as Trojan horses because they deliver anti-cancer treatments directly into tumors. Some ADCs have the additional ability to kill off neighboring cancer cells even though they have a lower expression level of the target.

Dr. Mahtani, who has been active in clinical research for more than two decades, is also a co-first author of the study results being released at ASCO for “Multicenter Retrospective Cohort Study of the Sequential Use of the Antibody-drug Conjugates (ADCs) Trastuzumab Deruxtecan (T-DXd) and Sacituzumab Govitecan (SG) in Patients with HER2-low Metastatic Breast Cancer (MBC): Updated Data and Subgroup Analyses by Age, Sites of Disease, and Use of Intervening Therapies.”

Dr. Mahtani will also be leading a poster presentation, “Activating HR+/HER2- and Triple Negative Breast Cancer Care Teams and Their Patients in Shared Decision-Making.” It is scheduled for June 1 at 9 a.m. CDT. The study, at five community cancer clinics, highlighted the misalignment in treatment goals between breast cancer patients and healthcare professionals.

“We are not always on the same page,” she said. “Clinicians and patients must work together to make decisions about everything from testing to treatment, balancing risk and outcomes with patient desires. The first step toward shared decision-making is to make sure our goals are aligned.”

The project involved the creation of a downloadable toolkit for educational purposes.

Dr. Mahtani's presentations are among many at ASCO featuring Miami Cancer Institute's experts on glioblastoma and brain metastases, breast cancer and HPV-related cancers.

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