BCC 2025 | Limitations and potential biomarkers for ADCs in breast cancer
Sara Tolaney, MD, MPH, Dana Farber Cancer Institute, Boston, MA, provides an overview of current biomarkers for antibody-drug conjugates (ADCs), stating that there is a need for more robust and accurate methods to measure target expression. Developing quantitative assays may be key to improving our understanding of biomarker efficacy, and proposes integrating biomarkers, such as circulating tumor DNA (ctDNA) to select patients who may benefit from ADCs. This interview took place at the 2025 St. Gallen International Breast Cancer Consensus Meeting in Vienna, Austria.
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Transcript
Right now we have no biomarkers in essence for most of the ADCs. I think with T-DXd, certainly there is some data to suggest maybe degree of HER2 expression may predict even more robust efficacy. But with TROP2, for example, at least in the metastatic setting, it hasn’t panned out. But I don’t think we’re really measuring target expression correctly. I think immunohistochemistry is probably a very poor way of being able to look at target expression...
Right now we have no biomarkers in essence for most of the ADCs. I think with T-DXd, certainly there is some data to suggest maybe degree of HER2 expression may predict even more robust efficacy. But with TROP2, for example, at least in the metastatic setting, it hasn’t panned out. But I don’t think we’re really measuring target expression correctly. I think immunohistochemistry is probably a very poor way of being able to look at target expression. I think developing robust quantitative assays may get us there. So for now, I don’t think we have a great predictor of benefit. I think we could think, however, about integrating biomarkers to select patients such as using something like circulating tumor DNA and looking at ctDNA clearance, and could that select which patients are having early benefit and then allow us to figure out which patients can get away with an ADC by itself.
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