Research To Practice | Oncology Videos Breast Cancer — 5-Minute Journal Club Issue 2 with Dr Erika Hamilton: Defining the Role of TROP2-Directed Antibody-Drug Conjugates
Sep 1, 2025
Dr Erika Hamilton, a medical oncologist and ADC researcher, offers clinical perspectives on TROP2-directed therapies. She discusses distinct toxicities of different ADCs and practical management tactics. Conversation covers ILD vigilance, mucositis and steroid mouthwash, prolonged antiemetic needs, eye care, PRIMED neutropenia prevention, CNS activity of datopotamab, and challenges in sequencing ADCs.
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Treat ADCs As Distinct Drugs
- Do not mentally group all ADCs together because each has unique toxicities and management needs.
- Use agent-specific prophylaxis like steroid mouthwash for Dato-DXD to prevent mucositis early and consistently.
Act Early For ADC-Related ILD
- Hold ADCs at the first sign of interstitial lung disease because early action can prevent progression to fatal ILD.
- Do not rechallenge with the same ADC after symptomatic or grade 2+ ILD per current guidance.
Prophylax Mucositis Upfront
- Use prophylactic steroid mouthwash four times daily from the start of Dato-DXD to reduce mucositis incidence and severity.
- Expect mucositis to be hard to resolve and maintain prevention rather than waiting to treat established sores.