Personalized Antibody-Drug Conjugate Therapy

Let’s talk about getting in a trial. No, not a legal trial, a medical trial for a possible new cancer therapy. Yes, that’s what gets my attention and offers some hope right now.

“Personalized Antibody-Drug Conjugate Therapy Based on RNA and Protein Testing for the Treatment of Advanced or Metastatic Solid Tumors” (The ADC MATCH Screening and Treatment Trial) (NCT06311214) Phase II

This trial is based on pioneering research by Dr Chen and her team at UCSD. The research is moving into the medical world with three “arms” or sub-studies. Each one targets a different part of cancer, including TROP-2 expression like I have. Dr. Choy and Dr. Vu are leading the trial team at Moores Cancer Center at UCSD in San Diego.

I had a Tempus Assay, which I have written about before. My Tempus shows I have both TROP-2 and one other target that the trial (aka study) are looking for. Each of the three sub-studies applies a different medical solution. For the TROP-2 Cohort, SN-38 is used (a chemo therapy). The brilliant part is that the chemo will be driven to the cancer cell by an antibody, with the chemo attached using a “linker.” When the antibody attaches to the cancer cell the “payload” of chemo is injected and it disrupts the cancer’s ability to divide, and that means PSCC death— that’s our hope.

So how do I get into this trial?

First, my Oncologist orders a Tempus Assay, which means a blood test to me, and a sequencing to the doctor. The sequencing calls out my TROP-2, which my doctor then can match to a study. I was excited to hear there is a study right at my hospital.

So how well do I match the cancer receptor the study is looking for?

Here’s a little background. When a report says 2+ or 3+ by IHC, it is talking about how strongly a cancer target shows up when the tumor is stained and examined under the microscope. Think of it as brightness. 0 is little to none, 1+ is faint, 2+ is moderate, and 3+ is strong. So when my report says I may be 2+ / 3+ by IHC for TROP-2, it means my cancer may be showing enough of that target on its surface to get the trial’s attention.

For me, that matters because this is not just a technical footnote buried in lab language. It is one of the ways doctors decide whether a tumor may be a real match for a targeted drug. In plain English, 2+ / 3+ means there may be enough TROP-2 present for the treatment to have something real to grab onto. That does not mean guaranteed success. It does not mean automatic entry into the trial. But it does mean the signal may be strong enough to move the conversation forward.

The important catch is that my Tempus report is making a prediction based on RNA expression, not giving the final word. The trial still wants confirmatory IHC testing from its own central lab. So for now, I read this as hopeful but unfinished: not proof, not promise, but a real signpost.

In cancer land, sometimes that is how the next door appears—not flung open, but outlined in enough light that you know where to walk. Watch this space.

—Ty