Wait, what did you say?!

How many times in the past have we seen gaudy initial high response rates from traditional chemotherapies in small-cell lung cancer (SCLC) only for people to experience early relapse due to lack of persistence and durability?

Are we doomed to repeat this process with ADCs?

The initial attempts with Stemcentrx/AbbVie’s Rova-T, a DLL3 directed ADC ended in abject failure.  Proving the target wasn’t the issue, this hasn’t stopped a bispecific T cell engager (tarlatamab) from Amgen gaining approval in extensive stage disease (ES-SCLC).

Suppose we tweak a few elements with the next generation of ADCs and try swapping out the linker, payload, and antibody target – what then?

Perhaps another target with a chequered history to date has been B7-H3, with several modalities tested and a number of companies giving it a good go without much to show for their efforts.

This weekend we saw some new clinical data with a B7-H3 ADC. First reactions were positively rosy, yet there are a number of early warning signs and nuances to watch out for, as we explain in our latest review…

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