What factors do you use to decide between trastuzumab-deruxtecan and sacituzumab govitecan in HER2-low metastatic breast cancer?

Updated answer - 11/26/2024

There is currently limited data to guide the efficacy of trastuzumab deruxtecan (T-DXd) after progression on sacituzumab or vice versa. Since both drugs have a topoisomerase 1 inhibitor payload, cancers resistant to topoisomerase 1 inhibitors may be resistant to both drugs...

Updated answer - 12/04/2024

Key factors include:

• HER2 expression: T-DXd is preferred for HER2-low patients, as sacituzumab govitecan is not specifically studied in this subgroup.
• Line of therapy: Sacituzumab govitecan is often used after multiple chemotherapy lines, while T-DXd may be utilized earl...

Fam-trastuzumab deruxtecan (TDxd) and sacituzumab govitecan (SG) were and are being developed separately; in the course of their development, their paths collided leading to the key questions articulated above. There is no direct comparison between the 2 ADCs. The overarching hypotheses that led to ...

Tend to use T-Dxd in HER+ patients and sacituzumab in HER2 neg patients first.