Dr. Hurvitz on the Benefit of Trastuzumab Deruxtecan in HER2+ Breast Cancer with Brain Metastases

Sara A. Hurvitz, MD, associate professor, the David Geffen School of Medicine, the University of California, Los Angeles (UCLA), medical oncologist, medical director, Jonsson Comprehensive Cancer Center Clinical Research Unit, co-director, Santa Monica-UCLA Outpatient Oncology Practices, director, Breast Cancer Clinical Trials Program, UCLA, discusses the benefit of fam-trastuzumab deruxtecan-nxki (Enhertu) in a subset of patients with HER2-positive breast cancer and active brain metastases in the phase 3 DESTINY-Breast03 trial (NCT03529110).

A presentation at the 2021 San Antonio Breast Cancer Symposium focused on this subgroup from DESTINY-Breast03 who had a history of brain metastases at baseline, Hurvitz says. This analysis showed trastuzumab deruxtecan elicited an intracranial objective response rate of 63.9%, compared with 33.4% for patients treated with ado-trastuzumab emtansine (T-DM1; Kadcyla), Hurvitz explains.

These practice-changing data produced a role for trastuzumab deruxtecan in the second-line setting after first-line docetaxel, trastuzumab and pertuzumab for metastatic disease, Hurvitz explains. Moreover, these data encourage the evaluation of trastuzumab deruxtecan for patients with active brain metastases, Hurvitz adds. Overall, these are exciting data that are leading to ongoing studies of trastuzumab deruxtecan in early-stage treatment, which could produce more practice-changing data, Hurvitz concludes.