Antibody-drug conjugates (ADCs) have significantly improved the prognosis and safety profile for metastatic breast cancer (MBC) patients compared to traditional chemotherapy. However, treatment-related adverse events (TRAEs) remain a concern, with a meta-analysis of 23 clinical trials highlighting the prevalence and distinct toxicity profiles of currently approved ADCs.
- Gastrointestinal disorders were the most prevalent TRAEs across all treatments, affecting patients receiving Trastuzumab Deruxtecan, Trastuzumab Emtansine, and Sacituzumab Govitecan.
- Trastuzumab Deruxtecan was associated with a higher symptom burden than Trastuzumab Emtansine, particularly in terms of gastrointestinal disorders.
- Sacituzumab Govitecan also showed a higher symptom burden compared to Trastuzumab Emtansine, with blood system disorders and gastrointestinal disorders being the most prevalent.
The study emphasizes the need for healthcare providers to understand the specific TRAEs associated with each ADC to improve supportive care, including symptom management and palliative care. This knowledge is crucial for designing personalized and risk-stratified care pathways for MBC patients, ultimately enhancing their quality of life and treatment outcomes.
ADCs represent a targeted therapy class that combines monoclonal antibodies with cytotoxic payloads, designed to selectively target cancer cells while minimizing systemic toxicity. Despite their advantages, the occurrence of TRAEs, including gastrointestinal toxicities, haematological toxicities, and new uncommon toxicities like interstitial lung disease and ocular disorders, necessitates ongoing research and optimization of ADC designs to improve their efficacy and safety profiles.
