In a session at the 2023 Specialty Pharmacy Next meeting, Val Adams, PharmD, broke down therapeutic improvements in non-small cell lung cancer (NSCLC), identified the current clinical therapy limitations, and also highlighted new approaches to continue to improve lung cancer outcomes.

According to Dr Adams, there are two unment needs that he identified. “We don’t cure most patients with NSCLC, and we need better identification off responding and nonresponding patients.” Additionally, he said there is a need to overcome resistance to current treatments.

Dr Adams highlighted use of bispecific agents in cancer. According to Dr Adams, bispecific is “An artificial protein that can simultaneously bind to two different types of antigens or two different epitopes of the same antigen.”

“Currently 158 clinical trials with patients with lung cancer – 44 phase I/II, 12 phase II, and 1 phase III (remainder are phase I).”

Dr Adams explained the various potential mechanisms of action of bispecific proteins. They include:

• Bringing cells together (BiTE)
• Interfering with receptor signaling
• Engaging ADCC and/or compliment

The current NSCLC bispecific pipeline includes the following drugs:

• AK104
• Zenocutuzumab
• KN046
• AK112
• GEN1046
• Catumaxomab
• Amivantamab.

For antibody drug conjugates, the pipeline includes:

• Farletuzumab Ecteribulin
• MRG003
• Ozuriftamab Vedotin
• Mecbotamab Vedotin
• Ladiratuzumab Vedotin
• Tusamitamab Ravtansine
• Patritumab Deruxtecan
• Telisotuzumab Vedotin
• Trastuzumab Deruxtecan

Overall, Dr Adams said that the most exciting approaches for NSCLC treatment include bispecific antibodies – BiTE; antibody-directed cytotoxic therapies; new and better tyrosine kinase inhibitors; new combinations; and new targets.