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TROP2 ADCs in Metastatic TNBC: Addressing Challenges of Immunotherapy-Ineligible Patients

Clinical Thought

For patients with metastatic triple-negative breast cancer who are not candidates for immunotherapy, treatment selection remains challenging because of aggressive disease biology, high symptom burden, generally poor outcomes, and variable access to emerging therapies across the globe. This commentary examines expert perspectives on the evolving role of TROP2-directed antibody–drug conjugates (ADCs), including sacituzumab govitecan and datopotamab deruxtecan, with attention to treatment sequencing, concerns for ADC availability, toxicity-informed treatment selection, and care team readiness for implementing ADC-based therapy in routine practice.

Released: August 18, 2026

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Provided by

Provided by Clinical Care Options, LLC dba Decera Clinical Education.

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Supporters

AstraZeneca

Daiichi Sankyo, Inc.

Target Audience

This program is intended for oncologists and the multidisciplinary team caring for patients with metastatic triple-negative breast cancer, including advanced practice providers, nurses and nurse navigators, patient navigators, pharmacists, and eye care specialists (ophthalmologists and optometrists).

Learning Objectives

Upon completion of this activity, participants should be able to:

  • Interpret current and emerging clinical evidence for TROP2 ADC–based strategies in immunotherapy-ineligible mTNBC, including implications for first-line and later-line treatment planning

  • Individualize treatment selection and sequencing for patients with mTNBC who are not candidates for immunotherapy, integrating prior therapy exposure, disease burden, comorbidities, toxicity risk, and patient preferences

  • Implement multidisciplinary monitoring, toxicity-prevention, and AE-management pathways for patients receiving TROP2-directed therapy, including timely triage and oncology–eye care coordination when clinically indicated

Financial Disclosures

Primary Author

Thomas Bachelot, MD, PhD: consultant/advisor/speaker: AstraZeneca, Daiichi Sankyo, Lilly, Novartis, Pfizer.

Mafalda Oliveira, MD, PhD: consultant/advisor/speaker: AstraZeneca, Daiichi Sankyo, Gilead, Lilly, MSD, Novartis, Pfizer, ProteinQure, Roche.