Explore pharmacogenomic determinants of toxicity. Sacituzumab govitecan is more toxic among patients with certain UGT1A1 polymorphisms (5-10% of all pts). Other genes may be relevant for different ADCs, allowing to adapt the dose upon the genomic background of the patient.
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Photo of Paolo Tarantino taken from Twitter
Dec 15, 2023, 05:57
Paolo Tarantino: In our recent Nature Review we suggested some strategies to mitigate toxicity of novel ADC
Paolo Tarantino, clinical research fellow at the Dana-Farber Cancer Institute, shared a post on X/Twitter:
“Unfortunately true: novel ADCs are much more potent and effective than 1st gen ones, yet the higher potency comes at the cost of more chemo-related toxicities. In our recent Nature Review we suggested some strategies to mitigate toxicity of novel ADC
Optimize the dose and schedule. Randomized studies with T-DXd are showing that lowering the dose can reduce toxicity and retain efficacy in certain indications. Response-adapted strategies are being studied to adapt the dose based on the response to the regimen.
Develop smart monitoring devices. Many are in development to achieve a fast, easy and comfortable home monitoring of vital signs or other parameters that may allow for an early diagnosis (and better treatment) of ADC-related toxicities.
Develop a new generation of safer ADCs. This will likely need molecular adaptations in each ADC component: making the antibody more specific, optimizing linker stability and the tumor-specificity of the payload. Many innovative ADCs are being tested, the future is bright.”
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Source: Paolo Tarantino/X
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