Vishal Navani, Medical Director Early Phase Drug Development Group, Medical Director Lung Cancer Trial Group, Medical Oncologist at Alberta Health Services, shared a post on LinkedIn:
”Lung cancer is the model for precision oncology.
We routinely divide and treat non-small cell lung cancer by histology, PD-L1 expression and a litany of actionable oncogenes.
Yet in the second-line setting, many recent ADC studies have largely returned to an all-comer approach.
The negative readout for sigvotatug vedotin, following datopotamab deruxtecan and sacituzumab govitecan, does not mean ADCs have no future in NSCLC. But it does suggest that broad target expression is not enough.
A target being present does not mean the tumour is dependent on it. It does not tell us enough about antigen distribution, internalization, payload sensitivity, resistance biology, or the tumour microenvironment.
We learned the value of patient selection in lung cancer. We should not abandon that principle now.
The next generation of ADC trials should be built around biology from the start – not broad enrolment first and subgroup explanations later.
Thank you to the patients that trusted me with their care that I recruited onto this important study. Negative trials are only wasted if we fail to learn from them.
We owe it to patients to understand why these drugs did not improve outcomes, and to design the next studies better.”
Other articles featuring Vishal Navani on OncoDaily.