Ask AI

Later-Line TROP2 ADC Sequencing in Immunotherapy-Ineligible mTNBC

Start Activity
Text Module
Text Module Start Activity
This activity is available for 0.25 CME/CE credit(s).

Released: October 28, 2026

Expiration: April 27, 2027

See Activity Collection

Step 1 of 5

1 Pre Assessment 2 Text Module 3 Post Assessment 4 Evaluation 5 Credit

Later-line TROP2 ADC sequencing in immunotherapy-ineligible metastatic triple-negative breast cancer requires consideration of prior systemic therapy, biomarker status, and potential cross-resistance between ADCs. In this activity, learners will examine phase III evidence for sacituzumab govitecan, emerging data for investigational sacituzumab tirumotecan, and biomarker-informed alternatives after disease progression. Learners will also explore how prior ADC exposure, HER2 expression, germline BRCA1/2 status, rate of disease progression, organ function, residual toxicities from previous therapy, and clinical trial availability may help inform individualized treatment sequencing.

Thomas Bachelot
Thomas Bachelot, MD, PhD
2L+ TROP2 ADC in mTNBC

Pre Assessment

Assess your current knowledge and clinical approach before beginning your text module.
Begin Your Text Module
1.

How many people with breast cancer do you provide care for in a typical month?

2.

For those who practice in academic or community settings, please indicate your practice setting:

3.

A 58-year-old woman with mTNBC has a PD-L1 combined positive score (CPS) of 3 and negative germline BRCA1/2 testing. At the current progression, repeat biopsy of a hepatic metastasis confirms HER2 immunohistochemistry (IHC) 0 disease. Comprehensive next-generation sequencing identifies no actionable alterations, including NTRK1/2/3 or RET fusions. She previously received an anthracycline- and taxane-containing regimen for early-stage disease. After developing metastatic disease, she received first-line gemcitabine plus carboplatin, followed by capecitabine after disease progression. Imaging now demonstrates further progression of hepatic and pulmonary metastases. She has an Eastern Cooperative Oncology Group performance status of 1, preserved organ function, and persistent grade 1 peripheral neuropathy from prior taxane treatment. She has not received a TROP2-directed ADC and wishes to pursue active treatment while minimizing further neuropathy.

Based on her prior therapy, biomarker status, residual neuropathy, and lack of previous TROP2-directed ADC exposure, which systemic therapy represents the preferred next treatment?

Begin Your Text Module