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SABCS 2022 | DESTINY-Breast02: T-DXd in HER2+ metastatic breast cancer previously treated with T-DM1

Erika Hamilton, MD, Sarah Cannon Cancer Center, Nashville, TN, shares the primary results of the Phase III DESTINY-Breast02 (NCT03523585) trial of trastuzumab deruxtecan (T-DXd) versus treatment of physician’s choice in the third-line setting or more in patients with HER2-positive metastatic breast cancer previously treated with trastuzumab emtansine (T-DM1). The primary endpoint was progression-free survival (PFS). A significant improvement in PFS was observed of almost a year. However, following the results of the results of the Phase III DESTINY-Breast03 (NCT03529110) and an approval of T-DXd in the second-line setting, this patient population is likely to have been treated with T-DXd in the second-line as opposed to later lines of treatment. 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)

DESTINY-Breast02 was a trial that was pretty much done concurrent with DESTINY-Breast03. DESTINY-Breast02 looked at trastuzumab deruxtecan for patients with HER2-positive breast cancer that essentially were third-line and beyond and it was randomized against treatment of physician’s choice and these really were capecitabine with HER2 targeted agent combos.

What we saw was a statistically significant improvement in progression-free survival of essentially almost a year...

DESTINY-Breast02 was a trial that was pretty much done concurrent with DESTINY-Breast03. DESTINY-Breast02 looked at trastuzumab deruxtecan for patients with HER2-positive breast cancer that essentially were third-line and beyond and it was randomized against treatment of physician’s choice and these really were capecitabine with HER2 targeted agent combos.

What we saw was a statistically significant improvement in progression-free survival of essentially almost a year. This would’ve been extremely exciting and it still is exciting, but it kind of is put in perspective from the fact that we now have DESTINY-Breast03 data and approval for trastuzumab deruxtecan in the second-line setting. So, realistically, people are probably going to get trastuzumab deruxtecan in the second-line and not the third-line, and so that’s the only thing that kind of tempers these results, is now that we have access to trastuzumab deruxtecan earlier, it’s probably going to be used less in the later line.

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