Implementation Strategies: Real-World Treatment Implementation

Upcoming publications are focusing on real-world management strategies for adverse effects associated with ADCs, particularly sacituzumab govitecan, which is becoming a frontline therapy for mTNBC. Staying informed about these evolving best practices is crucial for optimizing patient care. Although several articles already address ADC toxicity management, ongoing research aims to refine approaches to improve tolerability and patient outcomes as these agents are more widely adopted in clinical practice.

In addition to more commonly discussed adverse effects such as neutropenia and diarrhea, other adverse events require attention—alopecia being a notable example. Studies investigating preventive measures such as scalp cooling for ADC-induced hair loss have so far shown no clear benefit. Consequently, hair loss remains an expected adverse effect for most patients treated with these drugs. It is important to have up-front conversations with patients regarding the possibility of alopecia and other toxicities, helping set realistic expectations and supporting informed decision-making before treatment initiation.

Despite these adverse effects, ADCs generally demonstrate improvements in progression-free survival and quality of life compared with traditional chemotherapy, as observed in data from multiple clinical trials. This benefit is especially relevant because disease progression, particularly involving visceral organs or the brain, often leads to symptom worsening and a decline in quality of life. By moving ADCs to earlier lines of therapy, the goal is not only to enhance clinical outcomes but also to preserve or improve patients’ quality of life, addressing both the physical and emotional burdens of mTNBC.