2L HER2+ metastatic breast cancer (post-trastuzumab + taxane) — Daiichi Sankyo + AstraZeneca
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#ASCO24
T-DXd vs T-DM in patients with HER2+ mBC: Updated survival results of DESTINY-Breast03
PFS➡️29.0 vs 7.2 mo
OS➡️52.6 vs 42.7 mo
ORR➡️79% vs 37%
ILD➡️16.7% vs 3.4% (all…
in 2L HER2+ metastatic breast cancer, in 10 years, from 2012 to 2022, we have reduced risk of progression and death by !!80%!!
- Lapatinib + cape 6.4 months
- TDM1 9.6 months
- TDXd 29.1 months
…
@giammi107 @ASCO Subsequent-line treatments (cross-over), adherence to subsequent-line treatments due to side effects, censored data, etc.
In clinical trials, OS is the gold standard endpoint, but in…
@dr_yakupergun @ASCO Maybe can you explain to a young doctor huge differences in pfs but not so much in os?
DESTINY-Breast03 established T-DXd as the 2L standard in HER2+ mBC by demonstrating unprecedented PFS and OS improvements over T-DM1. Long-term follow-up confirms durable benefit. T-DXd is now being studied in earlier lines (DESTINY-Breast09) and in HER2-low populations (DESTINY-Breast06).
Median: 28.8 months (T-DXd) vs. 6.8 months (T-DM1). HR 0.33 (95% CI 0.26-0.43), P<0.0001 T-DXd produced a >4-fold improvement in median PFS over T-DM1. Confirmed ORR 82.1% with T-DXd.
Median: 52.6 months (T-DXd, 95% CI 48.7-NE) vs. 42.7 months (T-DM1, 95% CI 35.4-NE). HR 0.73 (95% CI 0.56-0.94) Median OS 52.6 months (95% CI 48.7-NE) with T-DXd vs. 42.7 months (95% CI 35.4-NE) with T-DM1; HR 0.73 (95% CI 0.56-0.94) — 27% reduction in risk of death. Data cutoff Nov 20, 2023; median follow-up 41 months. ~10-month improvement in median OS — the longest OS reported in 2L HER2+ mBC. Published Hamilton et al., Nature Medicine 2024.
ILD/pneumonitis (all-grade) 16.7% with T-DXd vs. 3.4% with T-DM1 — requires active monitoring per class labeling. No new Grade ≥3 ILD cases in long-term follow-up. Other TRAEs consistent with established T-DXd profile.
✅ 2L standard of care for HER2+ mBC. DESTINY-Breast03 established T-DXd as the 2L standard in HER2+ mBC by demonstrating unprecedented PFS and OS improvements over T-DM1. Long-term follow-up confirms durable benefit. T-DXd is now being studied in earlier lines (DESTINY-Breast09) and in HER2-low populations (DESTINY-Breast06).