Aditya Bardia, MD, MPH

Aditya Bardia, MD, MPH, a medical oncologist at Massachusetts General Hospital and assistant professor of medicine at Harvard Medical School, discusses the efficacy of sacituzumab govitecan (Trodelvy) in patients with triple-negative breast cancer (TNBC).

Of the many antibody drug conjugates in clinical development at the moment, Bardia says the furthest along for metastatic TNBC is sacituzumab govitecan. This antibody drug conjugate targets TROP-2, which is overexpressed in most TNBC cells. It is also links to SN-38, the active metabolite of irinotecan (Onivyde) and is a topoisomerase inhibitor.

In a phase I/II clinical trial investigating sacituzumab govitecan in a heavily pretreated patient population (NCT01631552), there was impressive clinical activity with a response rate of over 30%, according to Bardia. In this setting, there is usually a response rate of about 10% to 15% with standard chemotherapy. The responses for this therapy were durable as well.

The toxicity profile for an antibody drug conjugate is usually caused by the toxic payload, and depending on the type of toxic payload, patients will have different adverse events (AEs). Because sacituzumab govitecan has an SN-38 toxic payload, common AEs include myelosuppression, such as neutropenia and thrombocytopenia; gastrointestinal AEs, such as nausea and diarrhea; and alopecia.

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Aditya Bardia, MD, MPH, discusses the efficacy of sacituzumab govitecan in patients with triple-negative breast cancer.

Antibody Drug Conjugate Sacituzumab Govitecan Shows Efficacy in TNBC

Aditya Bardia, MD, MPH, attending physician, Massachusetts General Hospital, Harvard Medical School, discusses the dual targeting of the HER2 receptor in patients with breast cancer.

Dual targeting of the HER2 receptor proved to better than single targeting, resulting in an improvement in pathological complete remission

Presence of a pathological complete remission correlated with increased disease-free survival and overall survival in patients with hormone receptor-positive and hormone receptor-negative disease

Dual Targeting of the HER2 Receptor

Aditya Bardia, MD, MPH, attending physician, Massachusetts General Hospital, Harvard Medical School, discusses recent advancements in the field of breast cancer.

Bardia says researchers are discovering new targets for hormone receptor-positive (HR+) breast cancer and are understanding more about endocrine resistance.

The results of the BOLERO-2 trial, which looked at the combination of aromatase inhibitors and mTOR inhibitors, have opened up the field to allow endocrine therapies to be combined with other targeted agents to potentially reverse endocrine resistance, Bardia says. These combinations will change the landscape of HR+ breast cancer.

For HER2+ breast cancer, Bardia thinks there will also be more combination therapies of HER2-directed therapies. Double combinations or even triple combinations would eventually obviate the need for chemotherapy, Bardia says.

Bardia thinks researchers need to do a better job in the field of triple negative breast cancer (TNBC). The problem with TNBC, Bardia says, is that it is difficult to know what to target. Finding a positive target will allow researchers and physicians to improve the outcomes of patients with TNBC.

Combining endocrine therapies with other targeted agents will potentially reverse endocrine resistance in HR+ breast cancer

Combinations of two or three HER2 directed therapies could eventually obviate the need for chemotherapy for patients with HER2+ breast cancer

Once researchers find a positive target in TNBC, they will be able to improve the outcomes of patients with TNBC

Aditya Bardia, MD, MPH, discusses recent advancements in the field of breast cancer.

Recent Advancements in the Field of Breast Cancer

Aditya Bardia, MD, MPH, attending physician, Massachusetts General Hospital, Harvard Medical School, gives an overview of the Snapshot assay for breast cancer.

Snapshot looks at the 130 most common mutations by using multiplex PCR to amplify mutations in breast cancer. In the 4-year review presented at the 2013 Breast Cancer Symposium, the assay was ordered by physicians for patients with metastatic breast cancer.

Bardia says that more genotyping assays are being offered by various institutions, and that is important for community oncologists to understand cancer mutations. Snapshot is a particularly good assay because it only looks at actionable mutations.

Snapshot is a multiplex PCR-based assay that looks at about 130 of the most common mutations in breast cancer

The assay was ordered by physicians for patients with metastatic breast cancer

More genotyping assays are being made available to community oncologists

It is important for community oncologists to understand cancer mutations

Snapshot only looks at actionable breast cancer mutations

Articles

Aditya Bardia, MD, MPH, Attending Physician, Massachusetts General Hospital, Harvard Medical School, gives an overview of the Snapshot assay for breast cancer.

Aditya Bardia, MD, MPH | Authors

Articles

Antibody Drug Conjugate Sacituzumab Govitecan Shows Efficacy in TNBC

Dual Targeting of the HER2 Receptor

Recent Advancements in the Field of Breast Cancer

The Snapshot Tumor Genotyping Assay for Breast Cancer