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On the other hand, switching to an ADC with a different payload class has been shown to overcome resistance and increase antitumor efficacy: in patients with HER2+ metastatic breast cancer, switching from a TOPI inhibitor-based ADC to a microtubule inhibitor-based ADC or vice versa yielded significantly higher objective response rates and progression-free survival than sequencing two ADCs with the same payload class 248,249

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