Antibody–drug conjugates in breast cancer: the first-line and curative setting
- Study type
- Review article
- Design
- Narrative review (Curr Opin Oncol)
- Source
- Current Opinion in Oncology · 2026
In plain words
There are new drugs called "antibody-drug conjugates" that link an antibody to a powerful anticancer drug. These drugs, which used to be given only after several other treatments had stopped working, are now used as the first treatment for metastatic disease and even to treat early breast cancer. They now have a place in the main types of breast cancer. One of their important side effects is lung inflammation (interstitial lung disease), so you should be watched, with your doctor's guidance, for symptoms such as cough or shortness of breath.
Key results
Study population
This is a review and did not enrol patients. It examines data from trials conducted in HER2-positive, triple-negative (TNBC) and hormone receptor-positive/HER2-negative breast cancer.
Endpoints
This is a review and has no specific primary or secondary endpoint. The abstract examines the DESTINY-Breast09, DESTINY-Breast05, DESTINY-Breast11, ASCENT-04/KEYNOTE-D19, TROPION-Breast02 and ASCENT-03 trials in terms of their impact on standards of care. The numbers and quantitative results of these trials are not given in the abstract.
Safety and side effects
The abstract emphasises the need for proactive monitoring for interstitial lung disease (ILD) with all approved agents. No quantitative data on grade ≥3 adverse events are given in the abstract.
Clinical significance and place in guidelines
According to this review, ADCs are now regulatory- and guideline-endorsed preferred first-line options in all major breast cancer subtypes, both in metastatic disease and in perioperative treatment. These options include T-DXd in HER2-positive breast cancer, sacituzumab govitecan plus pembrolizumab in PD-L1-positive metastatic TNBC, and Dato-DXd or sacituzumab govitecan in metastatic TNBC not suitable for immunotherapy. ILD monitoring is essential. The exact status of approvals and guidelines should be checked in official sources (FDA, NCCN, etc.) and with an oncologist.
Limitations
This paper is a narrative review and its abstract does not present the numbers and quantitative results of the trials. Remaining challenges noted in the abstract: sequencing among ADCs with topoisomerase I inhibitor payloads, and awaiting mature survival results from the perioperative trials.
This summary was prepared by the editorial team from the published paper; the original paper is the final reference. Read the original abstract on PubMed.