WCLC 2025 | Addressing controversies in biomarkers for ADCs in lung cancer

So there are many biomarkers emerging for ADCs in lung cancer and I’m privileged to be giving this talk where we are discussing IHC-based biomarkers, NGS-based biomarkers and case in point here is T-DXd or enhertu where you see of course HER2 by IHC is one of the biomarkers but in lung, it’s actually the HER2 mutation that gets looked at and not just the IHC. Of course, other biomarkers as in for Dato-DXd, you have biomarkers ranging from IHC-based to trophoblast 2 gene expression profile as well. And the response to therapy varying with the amount of biomarker expression. And so a lot of varied angles to come in when we discuss biomarker-based ADC application. And even though it should be all very, very precise and predictable based on the biomarkers, some of the conundrums will also be discussed wherein, for example, when you look at the troponin 1 and troponin lung 5, you see responses across the tumors, irrespective of just those that are trophoblast 2 positive. And even though trophoblast 2 positivity is ubiquitous in lung cancers, it is highly specific here to understand that most non-small cell lung cancers are going to be able to respond. The response is not as good in squamous, but non-small cell lung cancers are not necessarily being offered basis biomarker recognition. So I think a lot of the realization and discovery of biomarkers in ADCs is evolving. Some of them are very distinct and some others are coming through as we run our clinical trials.

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