Drug Development Department, International Center for Thoracic Cancers (CICT), Gustave Roussy, Villejuif, France.
Drug Development Department, International Center for Thoracic Cancers (CICT), Gustave Roussy, Villejuif, France.
Cancer Treat Rev. 2023 Jul;118:102572. doi: 10.1016/j.ctrv.2023.102572. Epub 2023 May 19.
BACKGROUND: Antibody drug conjugates (ADCs) represent a revolutionary drug class in cancer therapy, combining the precision of targeted therapy with the cytotoxic effects of chemotherapy. Promising activity of novel ADCs, namely Trastuzumab Deruxtecan and Patritumab Deruxtecan, has been observed in hard-to treat molecular subtypes, such as HER2-positive and heavily pretreated EGFR-mutant Non-Small Cell Lung Cancer (NSCLC). However, therapeutic advances are expected in certain subgroups of lung cancer patients, including non-oncogene-addicted NSCLC after failure of current standard of care (e.g., immunotherapy with or without chemotherapy, chemo-antiangiogenic treatment). Trophoblastic Cell Surface Antigen 2 (TROP-2) is a surface transmembrane glycoprotein member of the epithelial cell adhesion molecule (EpCAM) family. TROP-2 represents a promising therapeutic target in refractory non-oncogene-addicted NSCLC. METHODOLOGY: We performed a systematic literature search of the clinical trials about TROP-2 directed ADCs in NSCLC referenced in the pubmed.gov database, Cochrane Library database and clinicaltrial.gov database. RESULTS: First-in-humans ADCs targeting TROP-2, namely Sacituzumab Govitecan (SN-38) and Datopotamab Deruxtecan (Dxd), yielded promising activity signals in NSCLC with a manageable safety profile. Most common grade ≥ 3 adverse events (AEs) of Sacituzumab Govitecan included neutropenia (28 %), diarrhea (7 %), nausea (7 %), fatigue (6 %), and febrile neutropenia (4 %). Nausea and stomatitis were the most common all grade AEs with Datopotamab Deruxtecan; dyspnea, amylase increase, hyperglycemia and lymphopenia were reported as grade ≥ 3 AEs in less than 12 % of patients. CONCLUSION: As more effective strategies are needed for patients with refractory non-oncogene-addicted NSCLC, the design of novel clinical trials with ADCs targeting TROP-2 is encouraged as both a monotherapy or combination strategy with existing agents (e.g., monoclonal antibodies targeting immune checkpoint inhibitors or chemotherapy).
背景:抗体药物偶联物(ADC)代表了癌症治疗领域的一项革命性药物类别,将靶向治疗的精准性与化疗的细胞毒性作用相结合。新型 ADC,即曲妥珠单抗 deruxtecan 和 patritumab deruxtecan,在难以治疗的分子亚型中表现出了有希望的活性,例如 HER2 阳性和大量预处理的 EGFR 突变型非小细胞肺癌(NSCLC)。然而,在某些亚组的肺癌患者中,预计会有治疗进展,包括在当前标准治疗失败后的非致癌基因依赖型 NSCLC(例如,免疫治疗联合或不联合化疗,化疗-抗血管生成治疗)。滋养细胞表面抗原 2(TROP-2)是上皮细胞黏附分子(EpCAM)家族的表面跨膜糖蛋白成员。TROP-2 是难治性非致癌基因依赖型 NSCLC 有前途的治疗靶点。
方法:我们在 pubmed.gov 数据库、Cochrane 图书馆数据库和 clinicaltrial.gov 数据库中对 NSCLC 中靶向 TROP-2 的 ADC 进行了系统的文献检索。
结果:靶向 TROP-2 的首例人体 ADC,即 sacituzumab govitecan(SN-38)和 datopotamab deruxtecan(Dxd),在 NSCLC 中表现出了有希望的活性信号,且安全性可管理。Sacituzumab govitecan 最常见的≥3 级不良事件(AE)包括中性粒细胞减少(28%)、腹泻(7%)、恶心(7%)、疲劳(6%)和发热性中性粒细胞减少(4%)。datopotamab deruxtecan 最常见的所有等级 AEs 为恶心和口腔炎;呼吸困难、淀粉酶升高、高血糖和淋巴细胞减少在不到 12%的患者中报告为≥3 级 AE。
结论:由于需要为难治性非致癌基因依赖型 NSCLC 患者提供更有效的治疗策略,因此鼓励设计针对 TROP-2 的新型 ADC 临床试验,无论是作为单药治疗还是与现有药物联合治疗(例如,针对免疫检查点抑制剂或化疗的单克隆抗体)。
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