A Role for Biomarkers in Selecting Appropriate Patients for ADCs in NSCLC

This is a synopsis of a Peer Exchange video series featuring Benjamin P. Levy, MD, of Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; Solange Peters, MD, PhD, of University Hospital of Lausanne; Joshua K. Sabari, MD, of NYU Langone’s Perlmutter Cancer Center; Edward B. Garon, MD, MS, of UCLA Jonsson Comprehensive Cancer Center; and Marina Chiara Garassino, MD, of University of Chicago Medicine Comprehensive Cancer Center.

Dr Levy asks whether biomarker selection is needed for ADCs [antibody-drug conjugates] after phase 3 trials like TROPION-Lung01 showed efficacy without enrichment. Dr Peters responds that while having a biomarker is ideal philosophically, measuring and applying one can be difficult, as with Trop-2 expression and sacituzumab govitecan. She states histology may serve as a biomarker if the data shows differential benefit.

Dr Garon notes a biomarker helps increase relative benefit over standard therapy and lend credibility when enrolling patients, though lack of one doesn't preclude use if efficacy is proven, like with pembrolizumab/chemotherapy in PD-L1–low patients. As more ADCs emerge, Dr Sabari feels having biomarker selection strategies will become more important to guide optimal patient selection for each ADC’s unique toxicity profile.

In conclusion, the experts agree biomarkers are ideal to select patients most likely to benefit from ADCs but remain challenging to develop and apply. If an ADC shows benefit regardless of biomarker status, it can still be clinically useful in that setting.

*Video synopsis is AI-generated and reviewed by OncLive editorial staff.