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ASCO 2022 | DESTINY-Breast04: T-DXd provides significant improvement in OS + PFS in HER2-low mBC

Hope Rugo, MD, FASCO, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, talks on the results of the Phase III Destiney-breast04 (NCT03734029) trial investigating trastuzumab deruxtecan versus physicians choice of chemotherapy in HER2-low breast cancer. A total of 557 were included in the trial, including a small subset of 58 patients with triple-negative breast cancer (TNBC). HER2-low was defined as an immunohistochemistry (IHC) 1+ or 2+ without evidence of HER2 gene amplification and was centrally confirmed due to variation in what is considered 1+, 2+ or 0. The majority of patients were also HR-positive. Trastuzumab deruxtecan demonstrated a 49% reduction in risk of death or disease progression compared to chemotherapy in patients with HR-positive disease and 36% reduction in HR-negative. A significant improvement was observed in progression-free survival (PFS) and overall-survival (OS) in the entire population. Grade 1 or 2 nausea was the most common toxicity. There was an overall 10% rate of interstitial lung disease (ILD) or pneumonitis, resulting in 3 deaths (0.8%), highlighting the importance of the early identification of ILD. This interview took place at the American Society of Clinical Oncology (ASCO) 2022 Annual Meeting in Chicago, IL.

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