Robert Wesolowski, MD, a medical oncologist and associate professor-clinical, member, Translational Therapeutics Program, The Ohio State University Comprehensive Cancer Center­–James, discusses the potential future utility of fam-trastuzumab deruxtecan-nxki (Enhertu) in HER2-positive breast cancer.

Findings from the DESTINY-Breast01 trial (NCT03248492) demonstrated a response rate of approximately 60% with trastuzumab deruxtecan among patients with heavily pretreated HER2-positive breast cancer, says Wesolowski. These findings suggest that trastuzumab deruxtecan could be moved into earlier lines of treatment where ado-trastuzumab emtansine (T-DM1; Kadcyla) is currently the standard of care, Wesolowski explains. For example, trastuzumab deruxtecan may have clinical utility in the second-line or adjuvant settings in place of T-DM1, Wesolowski says. However, pulmonary toxicity remains a key concern when treating patients with trastuzumab deruxtecan, Wesolowski adds. 

The randomized phase 3 DESTINY-Breast05 trial (NCT04622319) is ongoing, comparing these therapies head-to-head in patients with high-risk HER2-positive breast cancer who have residual disease following neoadjuvant therapy, concludes Wesolowski. 

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Robert Wesolowski, MD, discusses the potential future utility of fam-trastuzumab deruxtecan-nxki in HER2-positive breast cancer. 



Dr. Wesolowski on the Potential Future Utility of Trastuzumab Deruxtecan in HER2+ Breast Cancer 

Robert Wesolowski, MD, a medical oncologist and associate professor-clinical at The Ohio State University Comprehensive Cancer Center, discusses the possibility of home administration of fixed dose pertuzumab (Perjeta) and trastuzumab (Herceptin) plus chemotherapy in patients with HER2-positive early breast cancer.

The regimen was examined in the phase 3 FeDeriCa (NCT03493854) trial and is ideal for patients who have poor intravenous access, who do not have a port, or who wish to remove their port, according to Wesolowski. However, the concept of home administration with the combination is controversial, as many providers are not comfortable with the idea of patients receiving the treatment at home, he says.

Motivated, reliable patients may be a good fit for this treatment strategy, especially since they will continue to be monitored by a healthcare professional regardless of whether the administration is done at home, Wesolowski concludes.

Robert Wesolowski, MD, discusses the possibility of home administration of fixed dose pertuzumab and trastuzumab plus chemotherapy in patients with HER2-positive early breast cancer.

Robert Wesolowski, MD

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Dr. Wesolowski on the Potential Future Utility of Trastuzumab Deruxtecan in HER2+ Breast Cancer

Dr. Wesolowski on Home Administration of Fixed-Dose Pertuzumab/Trastuzumab Plus Chemo in Early Stage HER2+ Breast Cancer