The Harmony VI lung cancer trial's confusing inclusion/exclusion criteria for high-risk patients highlights a critical debate: developing drugs in idealized settings can limit their applicability and create uncertainty for treating the actual patients clinicians see daily.
Unprecedented response rates (up to 72% in HER2 3+) for new ADCs in Phase 1/2 endometrial cancer trials are challenging the historical view of early trials as having low success. This shift encourages earlier patient enrollment in targeted therapy studies.
As numerous antibody-drug conjugates (ADCs) move to frontline cancer therapy, a key concern emerges: most use a small number of payloads (like topo-1 inhibitors). There is pessimism about whether sequencing different ADCs that share the same payload will be effective.
Emerging data in urothelial cancer suggests a potential solution to the ADC sequencing problem. After treatment with a Nectin-4 targeted ADC, using a second Nectin-4 ADC with a different payload (topo-1 inhibitor instead of MMAE) still demonstrated efficacy.