Videos

Komal Jhaveri, MD, FACP, explains data on the frontline standard of care treatment approaches for ER-positive HER2-negative mBC.

Standards of Care in the Frontline Treatment of ER+/HER2- mBC

Paolo Tarantino, MD, provides an overview of ER-positive, HER2-negative metastatic breast cancer (ER+/HER2- mBC), highlighting the prevalence, patient populations, and the typical prognosis.

Overview of ER+/HER2- Metastatic Breast Cancer (mBC)

Paolo Tarantino, MD, researcher, the European Institute of Oncology, clinical research fellow, Dana-Farber Cancer Institute, discusses the impact of the phase 3 DESTINY-Breast04 trial (NCT03734029) in the treatment of HER2-low breast cancer.

The study compared fam-trastuzumab deruxtecan-nxki (Enhertu) to a physician’s choice of chemotherapy in patients with HER2-low breast cancer that has been previously treated.

This trial affected treatment decisions for patients with HER2-low breast cancer, who represent a sizeable portion of the breast cancer population, Tarantino says. Data from DESTINY-Breast04 presented at the 2022 ASCO Annual Meeting demonstrated a benefit in overall response rate, progression-free survival, and overall survival for trastuzumab deruxtecan compared with chemotherapy.

Despite the advances made in HER2-low breast cancer, questions remain in this field, including if trastuzumab deruxtecan can elicit a benefit in patients with HER2-zero breast cancer, Tarantino explains. The phase 3 DESTINY-Breast06 trial (NCT04494425) will help investigators answer more questions about the utility of trastuzumab deruxtecan, Tarantino concludes.

Paolo Tarantino, MD, discusses the impact of the phase 3 DESTINY-Breast04 trial in the treatment of HER2-low breast cancer.


Dr. Tarantino on the Impact of the DESTINY-Breast04 Trial in HER2-Low Breast Cancer

Paolo Tarantino, MD, researcher, the European Institute of Oncology; clinical research fellow, Dana-Farber Cancer Institute, discusses the options available in the second line for patients with HER2-positive metastatic breast cancer.

The first-line treatment landscape in HER2-positive metastatic breast cancer has remained largely unchanged, with most patients still being treated with chemotherapy plus trastuzumab (Herceptin) and pertuzumab (Perjeta), Tarantino says. However, the second-line treatment arena was reshaped by the phase 3 DESTINY-Breast03 study (NCT03529110), which showed fam-trastuzumab deruxtecan-nxki (Enhertu) elicited better response rates and progression-free survival (PFS) data than ado-trastuzumab emtansine (Kadcyla; T-DM1), Tarantino explains. Specifically, trastuzumab deruxtecan demonstrated 

a median PFS that was not yet reached vs 6.8 months

Additionally, in the phase 2 HER2CLIMB trial (NCT02614794), tucatinib (Tukysa) plus capecitabine (Xeloda) and trastuzumab was shown to be highly effective in patients with active brain metastases, although compelling evidence also supports the use of trastuzumab deruxtecan in this population, Tarantino notes. Second-line T-DM1 might still be an effective option in frail patients or those with indolent disease, as it’s a well-tolerated and well-known drug, Tarantino says. However, trastuzumab deruxtecan has arisen as the preferred option for HER2-positive metastatic breast cancer based on recent data, Tarantino concludes.

Dr Tarantino on Second-line Treatment Selection in HER2+ Metastatic Breast Cancer

Paolo Tarantino, MD, clinical research fellow, Dana-Farber Cancer Institute, discusses the importance of the phase 3 DESTINY-Breast04 trial (NCT03734029) in HER2-low breast cancer.

The randomized, 2-arm, open-label, multicenter study compared fam-trastuzumab deruxtecan-nxki (Enhertu) to the physician’s choice standard of care in previously treated patients with HER2-low breast cancer.

DESTINY-Breast04 was the first phase 3 trial launched with the goals of confirming the paradigm of HER2-low disease, Tarantino says. The trial included patients with pretreated HER2-low tumors, including those with hormone receptor–positive and triple-negative breast cancer, Tarantino explains. To be randomized to receive trastuzumab deruxtecan or a standard-of-care chemotherapy, patients were required to have undergone at least 1 prior line of chemotherapy, Tarantino says.

Data from the trial showed trastuzumab deruxtecan elicited an improvement in progression-free survival and overall survival, compared with chemotherapy, Tarantino continues. More data from the pivotal trial are expected soon, and these findings could be practice changing in terms of how therapeutic decisions for this pretreated patient population is approached, Tarantino concludes.

Sponsored in part by Daiichi Sankyo. Content independently developed by OncLive

Paolo Tarantino, MD, discusses the importance of the phase 3 DESTINY-Breast04 trial in HER2-low breast cancer.


Paolo Tarantino, MD

Articles

Standards of Care in the Frontline Treatment of ER+/HER2- mBC

Overview of ER+/HER2- Metastatic Breast Cancer (mBC)

Dr. Tarantino on the Impact of the DESTINY-Breast04 Trial in HER2-Low Breast Cancer

Dr Tarantino on Second-line Treatment Selection in HER2+ Metastatic Breast Cancer

Dr. Tarantino on the Importance of the DESTINY-Breast04 Trial in HER2-Low Breast Cancer