Updated Findings on Datopotamab Deruxtecan in Urothelial Cancer Treatment
Funda Meric-Bernstam, MD, discusses updated findings from the phase 1 TROPION-PanTumor01 study of datopotamab deruxtecan-dlnk in heavily pretreated locally advanced or metastatic urothelial cancer.
Funda Meric-Bernstam, MD, chair of the Department of Investigational Cancer Therapeutics (Phase 1 Program) at The University of Texas MD Anderson Cancer Center, discusses what a community oncologist should get from updated findings from the phase 1 TROPION-PanTumor01 study (NCT03401385) of datopotamab deruxtecan-dlnk (Datroway) in patients with heavily pretreated locally advanced or metastatic urothelial cancer, presented at the 2025 ASCO Genitourinary Cancer Symposium.
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0:10 | This is an agent that is FDA-approved for breast cancer, not yet for urothelial cancer, but I think that it definitely is an agent with potential for urothelial cancer on the horizon. Also, it is something that I think can be considered as relatively safe, as it doesn't have neuropathy, so in a patient who's had problems with neuropathy, it could be a consideration, and again, with less pulmonary concerns compared with other drugs and pain options.
0:38 | We were aware of TROP2 as a target. And more recently, there has been an approval and then withdrawal of another ADC that targets TROP2. So, that was at least in part because of the challenge of managing cytopenia in a multicenter trial setting, and you could see how that would be very relevant to the community setting. So, from that standpoint, I think DATO-DXd very favorably compares, because really, we do not see cytopenia as an [adverse] effect, and that also enhances the possibility of combination.
1:16 | From the patient selection standpoint, this trial was an unselected trial, so we did not look for TROP2 expression for enrollment. And of course, we know that TROP2 is frequently expressed, but it is important to note, in some other diseases, there is data emerging that expression may matter and we can even further enhance that space. In lung cancer, there is exploration of quantitative imaging with a continuous scoring strategy. So, I think more is yet to come to see if we can better identify patients that would benefit even more from DATO-DXd either from the payload or from expression.
1:54 | It is definitely, I think, an active enough agent to start thinking about where we would position it. And again, given the exciting activity so far with enfortumab vedotin-ejfv [Padcev] and pembrolizumab [Keytruda], it will be interesting to see whether there are patients that would benefit from something targeted instead, if we had a selection strategy. And also, I think we are thinking about strategies like utilizing it in the adjuvant setting, or potentially in the adjuvant setting.
