Expert Point of View: Howard A. “Skip” Burris, MD

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I think we will see improvements with these drugs and hope that antibody-drug conjugates will be the future of chemotherapy.
— Howard A. “Skip” Burris, MD

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Howard A. “Skip” Burris, MD, President of Clinical Operations and Chief Medical Officer at Sarah Cannon Research Institute, Nashville, commented on the poster presentation for The ASCO Post. He said the results “fit the whole paradigm” that is desired for triple-negative breast cancer, which is to administer chemotherapy without producing undue toxicity and to maintain a positive quality of life. He noted that although sacituzumab govitecan is similar to ado-trastuzumab emtansine (formerly known as T-DM1; Kadcyla), it involves a novel chemotherapy agent and may be somewhat more targeted. “Here we have a different antibody, a different target, and a different cytotoxic,” explained Dr. Burris.

“The nice thing about SN-38 as a derivative of irinotecan is the lack of neuropathy. It’s a different chemotherapy drug than what we use now, and it’s fairly well tolerated,” he added.

Future of Chemotherapy

Dr. Burris sees sacituzumab govitecan as a bridge between antibody-drug conjugates such as ado-trastuzumab emtansine and the next generation. “I think we will see improvements with these drugs and hope that antibody-drug conjugates will be the future of chemotherapy,” he said, explaining there is a need to balance the “potency of the payload” with off-target effects.

“We started out by asking, ‘How much drug can we give?’ as opposed to—by targeting chemotherapy to the cancer cell—how little we can give to get the job done. We should change that paradigm. I think the next generation of these drugs will be more like that.” ■

Disclosure: Dr. Burris reported no potential conflicts of interest.

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Novel Antibody-Drug Conjugate Targets Triple-Negative Breast Cancer

The antibody-drug conjugate sacituzumab govitecan (IMMU-132) produced high objective response rates, many of them quite durable, in a multicenter study of heavily pretreated patients with metastatic triple-negative breast cancer, presented at the 2016 San Antonio Breast Cancer Symposium.1