Sara Hurvitz, MD, on the Benefit of Second-Line T-DXd in Subgroups of HER2+ Breast Cancer

Sara Hurvitz, MD, associate professor at the David Geffen School of Medicine, medical director of the Johnson Comprehensive Cancer Center Clinical Research Unit, co-director of the Santa-Monica- University of California Los Angeles (UCLA) Outpatient Oncology Practices, and director of the Breast Cancer Clinical Trials Program at the University of California Los Angeles, spoke with CancerNetwork® on future research efforts with fam-trastuzumab deruxtecan (T-DXd; Enhertu) and results from a subgroup analysis of the phase 3 DESTINEY-Breast03 trial (NCT03529110) in patients with unresectable or metastatic HER2-positive breast cancer.

Transcript:

Any patient with HER2-positive breast cancer appears to benefit from this therapy. The subgroup analysis does not indicate that there is a type of patient who wouldn’t benefit from T-Dxd compared with T-DM1. Regardless of whether or not they have visceral disease, whether or not they’ve received prior pertuzumab [Perjeta], if the hormone receptors are co-expressed, or if they have a history of brain metastases, all these groups appear to benefit from T-DXd compared with T-DM1.

The natural next step for evaluating T-DXd is to look at it in the first-line setting in patients who have not yet received therapy for metastatic disease. There’s an ongoing clinical trial [NCT05113251] looking at T-DXd compared with [docetaxel, trastuzumab, and pertuzumab] which is the standard option for patients right now based on the [phase 3] CLEOPATRA trial [NCT00567190]. Studies are also ongoing looking T-DXd in the adjuvant setting or curative setting, comparing T-DXd to T-DM1 [with] type of clinical trial design [similar to the phase 3 KATHERINE trial; NCT01772472]. We're going to very shortly in the coming next couple of years see a lot more data regarding this agent and potentially see T-DXd move up into earlier line settings.