T-DXd Plus Pertuzumab Could Redefine First-Line HER2+ Breast Cancer Management: With Paolo Tarantino, MD

Welcome to OncLive On Air®! I’m your host today, Jax DiEugenio.

OncLive On Air is a podcast from OncLive®, which provides oncology professionals with the resources and information they need to provide the best patient care. In both digital and print formats, OncLive covers every angle of oncology practice, from new technology to treatment advances to important regulatory decisions.

In today’s episode, we spoke with Paolo Tarantino, MD, about key updates in HER2-positive breast cancer presented at the 2025 ASCO Annual Meeting. Tarantino is a research fellow at Dana-Farber Cancer Institute in Boston, Massachusetts.

Dr Tarantino reviewed findings from the phase 3 DESTINY-Breast09 trial (NCT04784715), which evaluated fam-trastuzumab deruxtecan-nxki (T-DXd; Enhertu) plus pertuzumab (Perjeta) vs induction taxane plus trastuzumab (Herceptin) and pertuzumab (THP) in the first-line treatment of patients with HER2-positive metastatic breast cancer. The T-DXd regimen produced a median progression-free survival (PFS) of 40.7 months vs 26.9 months for THP. Tarantino emphasized the importance of interpreting results alongside differences in crossover, treatment duration, and interstitial lung disease risk.

He also highlighted data from the phase 3 PATINA trial (NCT02947685), which supported maintenance CDK4/6 inhibition in patients with hormone receptor–positive, HER2-positive disease, as well as neoadjuvant data from the phase 2 CompassHER2-pCR (NCT04266249) and NeoCART (NCT03154749) trials, which may help refine early-stage treatment approaches. Dr Tarantino discussed biomarker advances beyond immunohistochemistry, such as HER2 mRNA quantification, to improve patient selection for antibody-drug conjugates.

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