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TROP-2 in NSCLC

CME

Antibody‒Drug Conjugates Targeting TROP-2 in NSCLC: A Look to the Future

Physicians: Maximum of 1.00 AMA PRA Category 1 Credit™

Released: July 25, 2023

Expiration: July 24, 2024

CME/CE Information

Activity

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Health Disparities/Equity: Trial vs Clinic Populations

Stephen Liu, MD:
From a health disparity standpoint, our study populations are not always as diverse as our clinic populations. Dr Levy, in your experience, how representative are the study populations in which these drugs are being evaluated?

Benjamin Levy, MD:
I often call the patients who go on study “lung cancer triathletes” who may not be representative of the real world population. Looking at the data, our study populations are approximately 9 years younger (in their 60s) than the average patient with lung cancer at diagnosis (70 years of age).27 Our study populations are Eastern Cooperative Oncology Group performance status 0/1, which we do not always see in the clinic. The predominant study patient population is not representative of the country’s population of Black persons or other racial and ethnic minorities. We need to apply these drugs to a real world population to better understand how they work.

I do think and hope that we are at a true pivot point that has culminated in advocacy, both in the industry and by physicians who declare that we must do better at including a diverse group of patients in clinical trials. 

At our institution, we have outreach programs in different communities to better understand how we can engage the underrepresented and underserved in clinical trials. Also, the American Society of Clinical Oncology and Association of Community Cancer Centers have released recommendations on specific actions to improve access and clinical trial participation by underrepresented patient populations.28 There is a real need here, and we hope that with the engagement of clinical trial sponsors, patient advocacy groups, physicians, and academic institutions, we can do better.

Conclusion

Stephen Liu, MD:
Although we are early in the development of TROP-2‒directed ADCs, and they are still investigational for the treatment of lung cancer, the early trials have shown some exciting responses. Despite some differences in toxicity profile, there is general enthusiasm for both sacituzumab govitecan-hziy and datopotamab deruxtecan. 

I want to thank all of my colleagues for taking time from their busy schedules to participate in today’s discussion. I also want to thank the learners for your careful attention and interest in this topic. We hope that everyone is now more confident in their knowledge of how ADCs work and the currently understood benefits and limitations of TROP-2‒directed ADCs for treatment of NSCLC. Many ongoing clinical trials really will determine the future of how to best use these drugs to improve the lives of our patients. I encourage everyone to discuss the possibility of clinical trial participation with all of your patients with NSCLC.

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