Continued Investigation of T-DXd Shows Promise in Breast Cancer

Sarah Sammons, MD, medical oncologist, clinical investigator in the Breast Oncology Center, associate director of the Metastatic Breast Cancer Program, Dana-Farber Cancer Institute, highlights the need for further investigation into trastuzumab deruxtecan (Enhertu; T-DXd) in breast cancer treatment.

In this interview, she explains some areas for future research of T-DXd based on findings from an analysis of the DESTINY-Breast03 trial (NCT03529110). While she explains that there is a small amount of data in the HER2-low brain metastasis space at the moment, experts are awaiting more data to see how T-DXd performs in HER2-low brain metastasis.

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0:09 | T-DXd is also FDA-approved in patients with metastatic breast cancer that have low expression of HER2, and so now we are investigating whether or not T-DXd works for patients with low levels of HER2 and brain metastasis.

0:31 | We have a small amount of data in HER2-low brain metastasis so far. The patients with brain metastasis were analyzed retrospectively from the DESTINY-Breast04 clinical trial [NCT03734029], and it is looking like there is an intracranial response rate around 25% in those patients, which actually for HER2-low or historically, HER2-negative brain metastasis is respectable. It is promising and I think that we are awaiting more data on how T-DXd performs in HER2-low brain metastasis, but I think that is a promising area.

1:16 | I would also say that HER2 is expressed in other types of solid tumors, [including in] some [gastrointestinal] tumors, some endometrial cancer, and we just got an approval for T-DXd in all solid tumors that are HER2-overexpressed with an [immunohistochemistry] score of 3+. Those tumors also have a higher propensity that is high HER2-expressing to go to the brain. This could be an option for patients that are HER2-expressing with brain metastasis in other solid tumors, which is exciting.