Sara Hurvitz, MD, spoke to the difficulty of treating HER2-positive and advanced HER2-positive breast cancer and how the efficacy of novel agents such as fam-trastuzumab deruxtecan-nxki could make a difference in treating the disease.
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® about improvements in the treatment of HER2-positive breast cancer. She discussed the FDA approval of fam-trastuzumab deruxtecan (T-DXd; Enhertu) for patients with unresectable or metastatic HER2-positive breast cancer who have received prior anti-HER2-based treatments and its impact on the treatment paradigm.1
The approval was based on the results of the phase 3 DESTINEY-Breast03 trial (NCT03529110), assessing the use of T-DXd vs ado-trastuzumab emtansine (T-DM1; Kadcyla).2 The objective response rate was 79.7% (95% CI, 74.3%-84.4%) in the T-DXd arm vs 34.2% (95% CI, 28.5% vs 40.3%) in the T-DM1 arm.
Although HER2-positive breast cancer is now able to be treated with a number of HER2-targeted therapies, T-DXd is an agent that has demonstrated remarkable anti-tumor activity. HER2-positive breast cancer is a type of disease that is more aggressive biologically and [is] associated with worse outcomes including survival in the absence of HER2 targeted therapies. Although our HER2 targeted therapies are very important and have improved outcomes for patients, [those] diagnosed with metastatic disease that's HER2-positive still are not generally considered to be curable. T-DXd has achieved an impressive objective response, prolonged progression-free survival, and [yielded] a strong trend toward overall survival. All of these are improving outcomes for patients compared with the standard agents we have available for this disease.