Antibody-Drug Conjugates in the Management of Breast Cancer — Proceedings from a Session Held in Conjunction with the 2026 ASCO Annual Meeting

Antibody-drug conjugates (ADCs) are transforming breast cancer management by offering targeted, sustained responses in both metastatic and early-stage settings. Clinical data demonstrate significant improvements in progression-free and overall survival for patients with triple-negative, HER2-positive, and endocrine-resistant HR-positive disease. Key strategies involve sequencing ADCs like trastuzumab deruxtecan (TDXD) and datopotamab deruxtecan (DATO-DXD) while managing distinct toxicity profiles, including interstitial lung disease (ILD), stomatitis, and nausea. Experts emphasize the importance of prophylactic measures, such as steroid mouth rinses for stomatitis and aggressive anti-emetic regimens for TDXD, to maintain treatment adherence. Emerging research focuses on combining ADCs with immune checkpoint inhibitors to convert "cold" tumors into "hot" ones and optimizing maintenance approaches to personalize care. These advancements shift the treatment landscape, allowing for more aggressive, effective interventions even in high-risk, early-stage populations.