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Topics:
Breast Cancer • Medical Oncology • HER2+ • Targeted therapies • Journal Club ft. NEJM publications • Breast Cancer, Metastatic
Is DESTINY Breast-09 data sufficient for T-DXd/P to replace THP as the first line standard of care for HER2-positive metastatic breast cancer?
Is the ~14 mos PFS gain an appropriate trade off for the treatment related toxicity?
Answer from: Medical Oncologist at NCI-Designated Cancer Center
With the impressive improvement in PFS to a 1L PFS to a remarkable 40.7 months, T-DXd + P is definitely an attractive option. However, I do not think this will be an approach I use for all patients. For ER+ patients, a THP induction strategy, followed by maintenance HP + AI and palbociclib, is also ...
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Answer from: Medical Oncologist at Academic Institution
I do think it is sufficient to drive a change in the standard of care and allow for T-DXd/P to be an option for 1L HER2+ MBC. I don't think this means that all patients need to receive T-DXd/P, given the toxicity profile as well as the potential for a THP induction followed by PATINA or HER2CLIMB-05...