[en] [en] UNLABELLED: DESTINY-Breast01 (NCT03248492) evaluated trastuzumab deruxtecan (T-DXd; DS-8201) in patients with heavily pretreated HER2-positive metastatic breast cancer (mBC). We present a subgroup of 24 patients with a history of treated brain metastases (BM), a population with limited treatment options. In patients with BMs, the confirmed objective response rate (cORR) was 58.3% [95% confidence interval (CI), 36.6%-77.9%], and the median progression-free survival (mPFS) was 18.1 months (95% CI, 6.7-18.1 months). In patients without BMs (n = 160), cORR was 61.3% and mPFS was 16.4 months. Eight patients (47.1%) experienced a best overall intracranial response of partial response or complete response. Seven patients (41.2%) had a best percentage change in brain lesion diameter from baseline consistent with stable disease. Two patients (8.3%) with BMs and two (1.3%) without BMs experienced progression in the brain. The safety profile of T-DXd was consistent with previous studies. The durable clinical activity of T-DXd in this population warrants further investigation.
SIGNIFICANCE: Advances in treating HER2-positive metastatic breast cancer have greatly improved patient outcomes, but intracranial progression remains an important risk for which few therapeutic options are currently available. T-DXd demonstrated durable efficacy in patients with stable, treated BMs. This article is highlighted in the In This Issue feature, p. 2711.
Disciplines :
Oncology
Author, co-author :
Jerusalem, Guy ; Centre Hospitalier Universitaire de Liège - CHU > > Service d'oncologie médicale
Park, Yeon Hee ; Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Seoul, Republic of Korea
Yamashita, Toshinari ; Kanagawa Cancer Center, Yokohama, Japan
Hurvitz, Sara A ; University of California, Los Angeles, Division of Hematology-Oncology, UCLA Jonsson Comprehensive Cancer Center, Los Angeles, California
Modi, Shanu ; Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
Andre, Fabrice ; Gustave Roussy, Department of Immunology, Université Paris-Sud, Villejuif, France
Krop, Ian E ; Department of Medical Oncology, Yale Cancer Center, New Haven, Connecticut
Gonzàlez Farré, Xavier ; Instituto Oncológico Dr Rosell, Hospital General De Catalunya, SOLTI, Institut Oncològic, Barcelona, Spain
You, Benoit ; Medical Oncology Department, Institut de Cancérologie des Hospices Civils de Lyon, CITOHL, Department of Medical Oncology, Université Claude Bernard Lyon 1, Lyon, France
Saura, Cristina ; Vall d'Hebron University Hospital, Breast Cancer Unit, Medical Oncology Service and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
Kim, Sung-Bae ; Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
Osborne, Cynthia R ; US Oncology Research, McKesson Specialty Health, The Woodlands, Texas ; Texas Oncology, Baylor-Sammons Cancer Center, Medical Services, Dallas, Texas
Murthy, Rashmi K ; Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
Gianni, Lorenzo ; Department of Oncology, Infermi Hospital, AUSL della Romagna, Rimini, Italy
Takano, Toshimi ; Breast Medical Oncology Department, The Cancer Institute Hospital of JFCR, Tokyo, Japan
Liu, Yali ; Daiichi Sankyo, Basking Ridge, New Jersey
Cathcart, Jillian ; Daiichi Sankyo, Basking Ridge, New Jersey
Lee, Caleb ; Daiichi Sankyo, Basking Ridge, New Jersey
Perrin, Christophe ; Department of Oncology, Centre Eugène Marquis, Rennes, France
Editorial assistance was provided by Jenna M. Gaska, PhD (Articu-lateScience, LLC), Jill Seabrook, PhD, and Laura Halvorson, PhD (ApotheCom), and financially supported by Daiichi Sankyo and AstraZeneca.
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