
Dr. Ami Shah from Northwestern University moderated a comprehensive discussion with Drs. Megan Kruse and Ruta Rao on the evolving treatment landscape for patients with HER2-positive breast cancer. The program focused on interpreting emerging data from pivotal Phase 3 trials of HER2-directed antibody-drug conjugates across neoadjuvant, adjuvant, and metastatic settings.
Key topics included the DESTINY-Breast09, -11, and -05 trials demonstrating trastuzumab deruxtecan's (T-DXd) efficacy combined with pertuzumab in first-line metastatic disease (median PFS 40.7 vs 26.9 months), neoadjuvant therapy (67% vs 56% pathologic complete response), and adjuvant treatment for residual disease (92% vs 84% three-year invasive disease-free survival).
The discussion emphasized deep response assessment, with complete responses occurring by 8 months and deepest responses by 24 months on therapy. CNS disease management was highlighted as a critical consideration, with T-DXd's proven intracranial activity influencing treatment selection. Practical aspects included interstitial lung disease monitoring with high-resolution CT scans, proactive nausea management with multi-agent antiemetics including olanzapine, and dose reduction strategies maintaining efficacy while improving tolerability.





























