Reviewing the 100-year development history of tumor therapy, it has gone through three revolutions, and also led to the revolution of chemotherapy, targeted therapy. and immunotherapy. It can be said that change in drugs have driven the revolutionary evolution of each tumor treatment, giving each revolution Its own drug-related characteristics.
The era of chemotherapy broke the barrier of relying solely on surgery and radiotherapy for clinical treatment, paving the way for drug treatment of cancer. Chemotherapeutic drugs such as paclitaxel, docetaxel, irinotecan, and platinum have a wide range of applications, enabling combined approaches with surgery and/or radiotherapy. However, the systemic exposure of chemotherapy and radiotherapy affects the quality of life of cancer patients. In the era of targeted therapy, most drugs achieve specific targeting, reducing systemic toxicity. Rituximab and imatinib, representing antibody and small molecule targeted drugs, respectively, showcase the clinical strength of targeted therapy. This era introduces precision medicine into clinical practice, but unfortunately, the precise targeting design also limits the scope of drug indications. In the era of immunotherapy, PD-1/L1 antibody drugs not only demonstrate the advantages of immunotherapy but also reveal the pan-tumor potential once again. However, inherent drug resistance or inadequate response remain as limitations.
In the era of ADC drugs, what changes will occur in the tumor treatment paradigm? How will the pattern of tumor treatment evolve?
Currently, it is difficult to fully determine the ultimate impact of ADC drugs on the evolution of tumor treatment since innovative products are still emerging. However, based on the clinical manifestations of current products, we can observe that ADC drugs, like chemotherapy and immunotherapy, have successively filled clinical treatment gaps and reshaped treatment standards, continuously expanding the depth of disease treatment. Furthermore, ADC drugs continue to achieve clinical breakthroughs across the field of oncology, highlighting their broad treatment potential—an attribute perfectly explained by the mechanism of ADC drugs. Specific targeting reduces the systemic exposure toxicity of chemotherapeutic drugs, and the delivery of cytotoxic drugs enables their pan-tumor qualification.
Evidently, most of the innovative ADC therapy products on the market possess this potential, with particular attention drawn to ADC products targeting HER2 and TROP2. In particular, in head-to-head studies involving HER2-positive breast cancer patients, ADC therapy has shown superior clinical benefits compared to T-DM1. Undoubtedly, it will become a new treatment standard and present an inevitable challenge for similar products. Considering the clinical research landscape of Detrozumab, it is apparent that it encompasses end-line treatment, second-line treatment, first-line treatment, adjuvant therapy, and neoadjuvant therapy for HER2-positive breast cancer, covering the management of the entire disease course from early to late stages. This comprehensive approach demonstrates its profound impact on treatment outcomes.