Approaches to Sequencing for Metastatic HER2+ BC

Volkmar Mueller, MD: This is not the only development in HER2 [human epidermal growth factor receptor 2]–positive metastatic breast cancer. I am also excited about the data on trastuzumab deruxtecan. This was also approved by the European authorities, with a conditional approval based on the phase 2 data of the unrandomized DESTINY-Breast01 trial. This trial gave a remarkable response, but of course we lack randomized data. These trials are almost completed or completed already, so we are going look at that. We cannot use trastuzumab deruxtecan on a routine basis because it is not available in Germany unless there is a special situation. That might be different in other countries in Europe. We have to apply for it, and then we get an approval on an individual basis. We have also used this for several patients. In the HER2CLIMB study, we used trastuzumab deruxtecan, and I think it worked. All treatment sequence would be after T-DM1 [trastuzumab emtansine], tucatinib, and then trastuzumab deruxtecan.

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