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TROP2 PET → TROP2 ADC selection

Proposed: a TROP2 PET scan to choose between three TROP2 ADCs and predict who will respond, since tissue staining has not worked.

First-in-human TROP2 tracers exist (89Zr-antibodies, 68Ga/18F-nanobodies). No outcome data yet. Would also allow monitoring of antigen loss on progression and rational ADC sequencing.

TROP2 PET→ selectsAntibody-drug conjugate (ADC)diagnostic → therapeutic
Rationale
ASCENT showed benefit regardless of IHC TROP2, possibly because IHC on one archival sample misses heterogeneity and dynamics; whole-body PET could capture both.
Evidence
Concept; phase 1 imaging studies.

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