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Use a whole-body TROP2 scan instead of a single tissue stain to decide which patients get a TROP2 ADC, which one, and when to switch.
The proposal is to use a whole-body TROP2 PET scan, rather than a single tissue stain, to decide which patients receive a TROP2 ADC, which agent they get and when to switch. Baseline uptake and heterogeneity would predict benefit, and a fall in uptake at progression would signal antigen loss that should prompt a move to a non-TROP2 ADC rather than a second TROP2 agent. IHC on archival tissue failed to predict sacituzumab govitecan benefit, whereas PSMA PET already plays this role for Pluvicto and 89Zr-antibody and 68Ga-nanobody tracers image human tumours. The test is an imaging sub-study inside a first-line TNBC ADC trial, then a randomised PET-guided versus standard sequencing trial. At early-clinical maturity, it bears on the bottleneck Biomarkers are not validated or standardised.
For hormone-receptor-positive metastatic breast cancer that has already had chemotherapy, Dato-DXd controls the disease for longer with fewer severe side effects than chemotherapy, but does not help patients live longer, so it is not a standard option here. The result is a reminder that progression-free survival is a surrogate; regulators and clinicians should wait for survival data before adopting an ADC in a setting where later therapies are effective.
Sacituzumab govitecan is a standard second-line or later treatment for metastatic triple-negative breast cancer, roughly doubling survival compared with the chemotherapies it was tested against. Patients should expect neutropenia and diarrhoea, which are manageable with growth factor support and loperamide. Trials are now testing it earlier, in first-line combinations with pembrolizumab and after surgery for residual disease.
One of the most cited trial reports Europe PMC returns for Sacituzumab govitecan in Triple-negative breast cancer, so it is a natural first reading for anyone weighing the idea it is linked from. The record was linked automatically by title and abstract; read the abstract above and the paper itself before relying on any figure.
One of the most cited trial reports Europe PMC returns for Sacituzumab govitecan in Triple-negative breast cancer, so it is a natural first reading for anyone weighing the idea it is linked from. The record was linked automatically by title and abstract; read the abstract above and the paper itself before relying on any figure.
Shares ASCENT-03, TROPION-Breast02, ASCENT, TROP2 PET.
Shares ASCENT, TROPION-Breast01: datopotamab deruxtecan versus chemotherapy in pretreated hormone-receptor-positive breast cancer, and why a PFS win did not translate to survival, ASCENT: sacituzumab govitecan doubles survival in heavily pretreated metastatic triple-negative breast cancer, TROP2.
Shares ASCENT-03, TROPION-Breast02, TROP2 ADC roadmap: sacituzumab govitecan → Dato-DXd → sac-TMT → bispecifics and PET, TROP2.
Shares ASCENT-03, TROPION-Breast02, ASCENT-04 / KEYNOTE-D19, ASCENT.
Shares TROPION-Breast02, TROP2, Datopotamab deruxtecan, Sacituzumab govitecan.
Shares ASCENT-03, TROPION-Breast02, ASCENT-04 / KEYNOTE-D19, Triple-negative breast cancer (TNBC).
Shares TROPION-Lung01, TROP2, Datopotamab deruxtecan, Antibody-drug conjugate (ADC).
Shares TROP2, Datopotamab deruxtecan, Sacituzumab tirumotecan, Sacituzumab govitecan.