From Payload to Patient: Advanced Approaches to HER2, TROP2, and B7-H3 Antibody-Drug Conjugate (ADC) Safety

This activity was originally presented at the 2026 HOPA Annual Conference in New Orleans, LA.

Antibody-drug conjugates (ADCs) have rapidly transformed the treatment landscape for multiple solid tumors, including breast, lung, urothelial, and gynecologic malignancies. While ADCs offer targeted advantages, incorporating them into complex treatment regimens presents significant clinical challenges. As the number of ADC approvals increases, so does concern regarding toxicity attribution, particularly in combination regimens where it is difficult to distinguish whether an adverse event is driven by the ADC's payload, its target-mediated "off-tumor" effects, or a concomitant agent. This session will explore the tripartite structure of ADCs and how these components influence both therapeutic efficacy and distinct toxicity profiles. The pharmacist's role in reducing clinical uncertainty by implementing evidence-based monitoring, constructing prophylactic protocols, and leading interdisciplinary coordination will be emphasized. The included case-based discussions will address concepts ranging from the application of adverse event grading and dose modification criteria to toxicity prevention and patient counseling for delayed or home-based toxicities.

Target audience: Oncology pharmacists

Type of activity: Application

Release date: April 15, 2026

Expiration date: April 15, 2027

Learner level: Advanced

Time to complete activity: 1.0 hour

Fee: Free

Educational Objectives

At the completion of this activity, participants will be able to:

• Apply Common Terminology Criteria for Adverse Events-based grading and prescribing information guidance to differentiate and manage antibody-drug conjugate (ADC)-related toxicities in combination regimens
• Factor evidence-based monitoring and intervention strategies for ADC-specific toxicities into patient care workflows to ensure early detection, timely escalation, and improved patient safety
• Construct practical supportive care protocols and counseling frameworks for patients receiving ADC therapy, including prophylactic measures, coordination of care, and patient education on toxicity prevention and red-flag symptoms