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SABCS 2022 | Updated results of DESTINY-Breast03: T-DXd vs T-DM1 in metastatic HER2+ breast cancer

Erika Hamilton, MD, Sarah Cannon Cancer Center, Nashville, TN, shares the updated results of the Phase III DESTINY-Breast03 (NCT03529110), investigating trastuzumab deruxtecan (T-DXd) versus trastuzumab emtansine (T-DM1) in patients with metastatic human epidermal growth factor receptor 2-positive (HER2+) breast cancer. The primary endpoint was progression-free survival (PFS) by blinded independent central review (BICR) and a key secondary endpoint was overall-survival (OS). The trial had previously reported significant improvement in PFS with TDX-D compared to T-DM1, the previous second-line therapy for HER2+ metastatic breast cancer. The updated results observed a benefit in PFS of over 22 months with TDX-D compared to T-DM1. Although OS medians have not yet been reached, the OS is statistically different. This interview took place at the San Antonio Breast Cancer Symposium (SABCS) 2022 in San Antonio, TX.

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Transcript (edited for clarity)

So we saw updates from DESTINY-Breast03 at San Antonio here in 2022. This trial had previously reported a significant improvement in progression-free survival with trastuzumab deruxtecan, compared to the previous second-line therapy for HER2-positive metastatic breast cancer, which was T-DM1. We saw updates this year not only for progression-free survival, but also for overall-survival. For progression-free survival, we’re now seeing a benefit of over 22 months for trastuzumab deruxtecan, compared to T-DM1, so that’s almost two years difference, which is really just amazing...

So we saw updates from DESTINY-Breast03 at San Antonio here in 2022. This trial had previously reported a significant improvement in progression-free survival with trastuzumab deruxtecan, compared to the previous second-line therapy for HER2-positive metastatic breast cancer, which was T-DM1. We saw updates this year not only for progression-free survival, but also for overall-survival. For progression-free survival, we’re now seeing a benefit of over 22 months for trastuzumab deruxtecan, compared to T-DM1, so that’s almost two years difference, which is really just amazing.

We’re also, although overall-survival medians have not been reached, overall-survival is statistically different, and so we’re seeing not only an improvement of progression-free survival by almost two years, but also an improvement in overall-survival. Considering quite a few patients kind of crossed over, or set another way, ended up getting trastuzumab deruxtecan after they went off study, if they received T-DM1 in countries where it was approved, the fact that we’re still seeing overall survival benefits is even more impressive.

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