TROPION-Breast02: First-Line Datopotamab Deruxtecan in Metastatic TNBC

In this segment, the panel reviews the phase 3 TROPION-Breast02 trial evaluating first-line datopotamab deruxtecan (Dato-DXd) versus investigator’s choice of chemotherapy in patients with locally advanced, inoperable, or metastatic triple-negative breast cancer (TNBC) for whom immunotherapy was not an option. Dr. Francisco J. Esteva presents the study design, patient population, treatment regimens, and efficacy findings. The trial demonstrated improved median progression-free survival with Dato-DXd compared with chemotherapy (10.8 vs 5.6 months; hazard ratio, 0.57) and longer median overall survival (23.7 vs 18.7 months; hazard ratio, 0.79). Objective response rates and median duration of response also favored Dato-DXd. The discussion of safety and tolerability covers treatment-related adverse events, dose reductions, treatment discontinuations, and key toxicities, including stomatitis and interstitial lung disease or pneumonitis. Dr. Esteva also reviews patient-reported outcomes, the trial population’s characteristics, and limitations affecting clinical interpretation, including representation of African American patients and differences between study populations. The presentation concludes by emphasizing that TROPION-Breast02 should not be directly compared with other first-line trials because of differences in patient populations and study designs.